Provider Demographics
NPI:1811946460
Name:MATTHEWS, JAMES F (OD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:F
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:OD
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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
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-10
Last Update Date:2023-01-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC1501152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890914RMedicaid
NC0912WOtherBLUE CROSS/BLUE SHIELD NC
NCU48361Medicare UPIN
NC890914RMedicaid