Provider Demographics
NPI:1912968371
Name:MATZKIN, DENNIS C (MD)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:C
Last Name:MATZKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7405 SHALLOWFORD ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421
Mailing Address - Country:US
Mailing Address - Phone:423-855-8522
Mailing Address - Fax:423-855-8533
Practice Address - Street 1:7405 SHALLOWFORD ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421
Practice Address - Country:US
Practice Address - Phone:423-855-8522
Practice Address - Fax:423-855-8533
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2017-07-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA039169207W00000X
TN49461207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000639933IMedicaid
TN1530465Medicaid
GA000639933IMedicaid
TN1530465Medicaid