CRAIG K. MATHESON D.O. P.L.L.C. NPI 1205961745

NPI Information

CRAIG K. MATHESON, D.O., P.L.L.C. is a primary care clinic center in Scottville, MI. CRAIG K. MATHESON, D.O., P.L.L.C. NPI is 1205961745. The provider is registered as an organization entity type.
The provider Is Doing Business As Third Coast Family Practice.

The provider's business location address is:

821 W US HIGHWAY 10 31
SCOTTVILLE, MI
ZIP 49454-601
Phone: (231) 757-2500
Fax: (231) 757-9073

The provider's authorized official is Craig Kenneth Matheson .
The authorized official title is Owner And Sole Member and has the following contact phone number (231) 757-2500.

The CLIA number assigned to this NPI record is 23D1038209 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 2/23/2007 and was last updated on 2/17/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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