Provider Demographics
NPI:1760417612
Name:MATTHEWS, ARTHUR M JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ARTHUR
Middle Name:M
Last Name:MATTHEWS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:15190 COMMUNITY RD
Mailing Address - Street 2:SUITE 370
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-3485
Mailing Address - Country:US
Mailing Address - Phone:228-831-9699
Mailing Address - Fax:882-831-3908
Practice Address - Street 1:15190 COMMUNITY RD
Practice Address - Street 2:SUITE 370
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-3485
Practice Address - Country:US
Practice Address - Phone:228-831-9699
Practice Address - Fax:882-831-3908
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-12-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALMD.8123208800000X
LAMD.011742208800000X
MS07141208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00017429Medicaid
MS00017429Medicaid