DR. MATTHEW CAMPBELL ERICKSEN (NPI# 1285956797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285956797 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW CAMPBELL ERICKSEN |
| Credential | D.O. |
| Practice Address |
1155 W Parkview St Suite 2j Bolivar MO 65613-8279 |
| Practice Telephone | 4173287000 |
| Mailing Telephone | 6237346378 |
| Enumeration Date | 2010-02-25 |
| Last Update Date | 2016-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
2012015105 | MO | Allopathic & Osteopathic Physicians |
| Street Address |
1155 W PARKVIEW ST SUITE 2J |
| City | BOLIVAR |
| State | MO |
| Zip Code | 65613-8279 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679531545 | Walter Wayne Wolf IIi | Surgery | 1155 W Parkview St, Suite 1f, Bolivar, MO 65613-8279 | 2006-05-02 |
| 1265971865 | Jacob (jake) William Condren | Physician Assistant | 1155 W Parkview St, Suite 2d, Bolivar, MO 65613-8279 | 2017-02-15 |
| 1073829925 | Troy Morrison | Orthopaedic Surgery | 1155 W Parkview St, Suite 2d, Bolivar, MO 65613-8279 | 2010-08-28 |
| 1235395765 | Citizens Memorial Healthcare Clinics | Durable Medical Equipment & Medical Supplies | 1155 W Parkview St, Suite 2d, Bolivar, MO 65613-8279 | 2008-08-04 |
| 1851468987 | Martin S. Tyson | Surgery | 1155 W Parkview St, Suite 1g, Bolivar, MO 65613-8279 | 2006-11-30 |
| 1508979477 | Kenneth Ronald Smith | Orthopaedic Surgery | 1155 W Parkview St, Suite 2d, Bolivar, MO 65613-8279 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891301552 | Casablanca Care Center, LLC | Home Health | 524 S. Albany Avenue, Bolivar, MO 65613 | 2020-09-18 |
| 1669087045 | Revive Medical LLC | Durable Medical Equipment & Medical Supplies | 5000, S Scenic, Bolivar, MO 65613 | 2020-09-11 |
| 1669097119 | Melanie Nicole Beckham | Nurse Practitioner | 1100 South Springfield Ave, Suite B, Bolivar, MO 65613 | 2020-06-10 |
| 1932754744 | Caitlin M Williams | Specialist/Technologist | 1260 S Pike Avenue, Bolivar, MO 65613 | 2019-08-08 |
| 1073022406 | Jacquelyn Rose Kemnic | Dietitian, Registered | Heart Center, 1500 N Oakland Ave, Willard, MO 65613 | 2017-09-28 |
| 1164897161 | Ozarks Resource Group | Clinic/Center | 203 E. Broadway St., Bolivar, MO 65613 | 2015-12-02 |
| 1962895292 | Professional Christian Counseling | Counselor | 4888 S 139th Road, Bolivar, MO 65613 | 2015-03-11 |
| 1073916573 | Scott Leslie Dennis | Physician Assistant | 1500 North Oakland Ave, Citizens Memorial Hospital, Bolivar, MO 65613 | 2014-09-29 |
| 1053712109 | Citizens Memorial Hospital District | Pharmacy | 1301-b North Oakland, Bolivar, MO 65613 | 2014-09-09 |
| 1740680453 | Jamee M Stimpson | Occupational Therapist | 454 S. Main Avenue, Bolivar, MO 65613 | 2014-08-29 |
| Find all providers in zip 65613 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407047178 | Edment, LLC | Otolaryngology | 5780 Highway 54, Suite 113, Osage Beach, MO 65065-3043 | 2007-08-07 |
| 1194876805 | Edgar N Kemp IIi | Otolaryngology | 1605 South Baltimore, Suite B, Kirksville, MO 63501 | 2007-01-16 |
| 1336209675 | Richard Hyrum Woodland | Otolaryngology | 1602 N 2nd, Clinton, MO 64735-1192 | 2006-12-09 |
| 1629161864 | Kelly Douglas Burchett | Otolaryngology | 1605 South Baltomore, Suite B, Kirksville, MO 63501 | 2006-10-02 |
| 1023120110 | James Mead Gaunt | Otolaryngology | 1710 S Lafayette Ave, Sedalia, MO 65301-7542 | 2006-08-31 |
| 1457331324 | Kent Douglas Mcintire | Otolaryngology | 1331 W 32nd St, Joplin, MO 64804 | 2006-01-18 |
| 1457351033 | Frank W Shagets | Otolaryngology | 620 W 32nd St, Suite B, Joplin, MO 64804-2549 | 2005-07-26 |
| 1407490105 | Ear Nose Throat Medical Service | Otolaryngology | 4800 Mexico Rd Ste 103, Saint Peters, MO 63376-1666 | 2019-11-05 |
| 1730539974 | Talon Maningas D.o. LLC | Otolaryngology | 620 W 32nd St Ste B, Joplin, MO 64804-2528 | 2016-06-19 |
| 1609244193 | Heather A Curtis | Otolaryngology | 6500 Hospital Dr, Hannibal, MO 63401-6890 | 2015-09-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.