Provider Demographics
NPI:1912113259
Name:MATHEWS, ROY CLYDE (DO)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:CLYDE
Last Name:MATHEWS
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 1:20 HOUSTON ST
Mailing Address - Street 2:
Mailing Address - City:SHERWOOD
Mailing Address - State:AR
Mailing Address - Zip Code:72120-2525
Mailing Address - Country:US
Mailing Address - Phone:501-833-1986
Mailing Address - Fax:
Practice Address - Street 1:1520 RIVERFRONT DR
Practice Address - Street 2:SUITE 100
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72202-1724
Practice Address - Country:US
Practice Address - Phone:501-666-6377
Practice Address - Fax:501-663-5866
Is Sole Proprietor?:No
Enumeration Date:2007-05-15
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR-4648207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine