Provider Demographics
NPI:1821702077
Name:JAMES F. MATTHEWS OD PA
Entity Type:Organization
Organization Name:JAMES F. MATTHEWS OD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:F
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:803-367-3830
Mailing Address - Street 1:6211 JACK THOMAS DR
Mailing Address - Street 2:
Mailing Address - City:FORT MILL
Mailing Address - State:SC
Mailing Address - Zip Code:29707-0170
Mailing Address - Country:US
Mailing Address - Phone:803-367-3830
Mailing Address - Fax:803-746-0862
Practice Address - Street 1:2101 YOUNTS RD
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-8505
Practice Address - Country:US
Practice Address - Phone:704-893-5555
Practice Address - Fax:803-746-0862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-12
Last Update Date:2023-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty