Provider Demographics
NPI:1164425963
Name:SPRAGG, MATTHEW T (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:T
Last Name:SPRAGG
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-384-6562
Mailing Address - Fax:319-353-7006
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-384-6562
Practice Address - Fax:319-353-7006
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004-01333207P00000X
IA4155207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1378AOtherMATTHEW SPRAGG'S BCBS #
NC891378AMedicaid
NCP00184254OtherMATTHEW SPRAGG'S RRMCA #
NCI09595Medicare UPIN
NCP00184254OtherMATTHEW SPRAGG'S RRMCA #