DR. DAVID LEE MATLOCK (NPI# 1356543706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356543706 |
| Entity Type | Individual |
| Full Name | DR. DAVID LEE MATLOCK |
| Credential | M.D. |
| Practice Address |
1235 E Cherokee St Springfield MO 65804-2203 |
| Mailing Address |
Po Box 504274 Saint Louis MO 63150-4274 |
| Practice Telephone | 4178202115 |
| Practice Fax Number | 4178205344 |
| Mailing Telephone | 4178206128 |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2013-05-17 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 2011032953 | MO | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 125-051081 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | TRICARE | 440552485 | 01 |
| MO | 1356543706 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528053485 | David Matlock | Family Medicine | 105 Teke Burton Dr, Mitchell, IN 47446-1208 | 2005-09-16 |
| 1508132697 | David Neil Matlock Jr. | Pediatrics | 1 Childrens Way, Slot 512-19a, Little Rock, AR 72202-3500 | 2012-03-22 |
| 1063629673 | David Matlock | Obstetrics & Gynecology | 9201 W Sunset Blvd Ste 406, Los Angeles, CA 90069-3705 | 2007-05-16 |
| Street Address |
1235 E CHEROKEE ST |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-2203 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982600284 | Maria J Brazil | Anesthesiology | 1235 E Cherokee St, Anesthesia, Springfield, MO 65804-2203 | 2005-06-22 |
| 1275155533 | Kevin Painter | Technician/Technologist | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2020-05-10 |
| 1023638939 | Rebecca Sue Holcomb | Dietitian, Registered | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2020-04-21 |
| 1508486895 | Matthew Austin Myers | Pharmacist | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2020-04-16 |
| 1013544477 | Virginia Mclaughlin | Speech-Language Pathologist | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2020-03-25 |
| 1265068134 | Alissa Leirer | Speech-Language Pathologist | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2020-03-23 |
| 1558994848 | Karla Guinter | Pharmacist | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2020-02-15 |
| 1760037766 | Anya Illyuk | Nurse Anesthetist, Certified Registered | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2019-08-06 |
| 1346892122 | Bradley Sean Chapman | Nurse Anesthetist, Certified Registered | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2019-07-12 |
| 1942852959 | Alison Atherton | Nurse Anesthetist, Certified Registered | 1235 E Cherokee St, Springfield, MO 65804-2203 | 2019-07-10 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225650773 | Evan Alexander Jenkins | Emergency Medicine | 701 N 1st St Ste 220, Springfield, IL 62702-3757 | 2020-05-07 |
| 1518523810 | Center for Vein Restoration Ma LLC | Emergency Medicine | 3640 Main St Ste 302, Springfield, MA 01107-1134 | 2019-05-13 |
| 1477081453 | Breeanna Murphy | Emergency Medicine | 701 N 1st St Ste D220, Springfield, IL 62702-3757 | 2017-06-02 |
| 1851822431 | Sean Murray | Emergency Medicine | 2121 S 4th St, Springfield, IL 62703-3449 | 2017-03-24 |
| 1285093393 | Medexpress Urgent Care, PC - Massachusetts | Emergency Medicine | 1312 Boston Road, Springfield, MA 01119-1336 | 2016-02-17 |
| 1306220488 | Andrea Marie-gioia Spangler | Emergency Medicine | 1235 E Cherokee St Dept Of, Springfield, MO 65804-2203 | 2015-07-17 |
| 1134506488 | Medexpress Urgent Care, PC - Massachusetts | Emergency Medicine | 430 Cooley St, Springfield, MA 01128-1180 | 2015-05-06 |
| 1669805016 | Medexpress Urgent Care - Northern New Jersey, PC | Emergency Medicine | 200 Us Highway 22, Springfield, NJ 07081-3123 | 2013-08-20 |
| 1346582046 | Shannon Macritchie | Emergency Medicine | 3333 Riverbend Dr., Springfield, OR 97401 | 2013-03-20 |
| 1902156839 | Lindsey Michelle Krawczuk | Emergency Medicine | 3801 S. National Ave., Springfield, MO 65807 | 2012-09-18 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
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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.