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Contact Information

RANDALL J MATOS DPM PC
1103 DEWEY AVENUE
POTEAU, OK74953-4411
 Phone: 918-649-3777
 Fax: 918-649-3891
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for RANDALL J MATOS DPM PC

NPI # 1407876246
LBN Legal business name RANDALL J MATOS DPM PC
Authorized official RANDALL MATOS - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 07/21/2006
Last updated 03/04/2011 - About 15 years ago
Identifiers
OK License # 193
OK Medicaid 200199110A
OK Other DN2101 RAILROAD MEDICARE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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