Provider Demographics
NPI:1982648457
Name:MATTHEWS, RODNEY BURNETT (PT)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:BURNETT
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 DURNFORD HILL CT
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-4008
Mailing Address - Country:US
Mailing Address - Phone:251-626-5552
Mailing Address - Fax:
Practice Address - Street 1:1505 DAPHNE AVE
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-4298
Practice Address - Country:US
Practice Address - Phone:251-625-3178
Practice Address - Fax:251-625-3198
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH30132251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51509162OtherBLUE CROSS/BLUE SHIELD