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Contact Information

JOHN A MATTINGLY, MD
12 WOLF CREEK DR
SWANSEA, IL62226-2314
 Phone: 618-277-7912
 Fax: 618-277-7915
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Neuroradiology

2085N0700X
Indicates primary specialty

NPI Profile & details for JOHN A MATTINGLY · (Male)

NPI Number 1952355786
Status Active
Credentials MD
Entity Individual
Enumeration date 05/19/2006
Last updated 08/14/2025 - About 10 months ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036096843
  • IN License # 01066438A
  • KY License # 42628
  • MD License # D0068341
  • MO License # 103379
  • IL Medicaid 0360916843
  • IL Medicaid 366096843
  • Other 376069 HEALTHLINK
  • Other P01026934 RR MEDICARE
Hospital affiliation(s)
  • AUDRAIN MEDICAL CENTER - (Acute Care)
    620 E MONROE
    MEXICO, MO 65265
  • CHRISTIAN HOSPITAL NORTHEAST - (Acute Care)
    11133 DUNN ROAD
    SAINT LOUIS, MO 63136
  • SSM DEPAUL HEALTH CENTER - (Acute Care)
    12303 DEPAUL DRIVE
    BRIDGETON, MO 63044
  • SSM ST CLARE HEALTH CENTER - (Acute Care)
    1015 BOWLES
    FENTON, MO 63026
  • ST MARYS HEALTH CENTER - (Acute Care)
    100 ST MARY'S MEDICAL PLAZA
    JEFFERSON CITY, MO 65101
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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