Provider Demographics
NPI:1720051121
Name:BARTON, MATTHEW S (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:S
Last Name:BARTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NE SAINT LUKES BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-6007
Mailing Address - Country:US
Mailing Address - Phone:816-347-5600
Mailing Address - Fax:816-347-5674
Practice Address - Street 1:20 NE SAINT LUKES BLVD STE 350
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-6007
Practice Address - Country:US
Practice Address - Phone:816-347-5600
Practice Address - Fax:816-347-5674
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2019010176207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB94000826OtherMEDICARE
NV1720051121Medicaid
NVVWCGZTOtherMEDICARE GROUP
NV2018017Medicaid
NV30833Medicare PIN