Provider Demographics
NPI:1730462060
Name:MCMATH, BEN F III (PHD)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:F
Last Name:MCMATH
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10980 MEADOWS CIR
Mailing Address - Street 2:
Mailing Address - City:VANCE
Mailing Address - State:AL
Mailing Address - Zip Code:35490
Mailing Address - Country:US
Mailing Address - Phone:205-310-4497
Mailing Address - Fax:
Practice Address - Street 1:902 MAIN AVE
Practice Address - Street 2:STE G
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-4434
Practice Address - Country:US
Practice Address - Phone:205-310-4497
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-22
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1489103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical