NPIMap

Organization Active NPI

Mattox Family Physicians, Inc

  • Family Medicine Physician
  • Angola, IN
National Provider Identifier
1790830693
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
01052822A Issued in IN
Legal business name
MATTOX FAMILY PHYSICIANS, INC
Practice address
3250 Intertech Dr Ste a
Angola, IN 46703-7224
Phone
(260) 665-2646
Fax
(260) 665-8707
NPI assigned
Jan 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dean L Mattox II, M.D.
Title
President
Phone
(260) 665-2646

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 01052822A IN Primary

Addresses

Primary practice location

3250 Intertech Dr Ste a
Angola, IN 46703-7224

Mailing address

3250 Intertech Dr Ste a
Angola, IN 46703-7224
Phone (260) 665-2646

Other identifiers 1

IdentifierTypeStateIssuer
200317780MedicaidIN

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262563200000",
    "number": "1790830693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3250 INTERTECH DR STE A",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037224",
            "telephone_number": "260-665-2646",
            "fax_number": "260-665-8707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 INTERTECH DR STE A",
            "city": "ANGOLA",
            "state": "IN",
            "postal_code": "467037224",
            "telephone_number": "260-665-2646",
            "fax_number": "260-665-8707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATTOX FAMILY PHYSICIANS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-24",
        "last_updated": "2010-01-04",
        "status": "A",
        "authorized_official_last_name": "MATTOX",
        "authorized_official_first_name": "DEAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-665-2646",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01052822A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200317780",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Angola, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.