Provider Demographics
NPI:1477158269
Name:MATHEWS, MARCUS BRENDEN (CRNA)
Entity type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:BRENDEN
Last Name:MATHEWS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3046 E TANOAK CIR
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-1221
Mailing Address - Country:US
Mailing Address - Phone:971-998-5377
Mailing Address - Fax:
Practice Address - Street 1:368 E RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-6896
Practice Address - Country:US
Practice Address - Phone:435-767-0404
Practice Address - Fax:260-432-9812
Is Sole Proprietor?:No
Enumeration Date:2020-12-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9654723-8901367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty