Provider Demographics
NPI:1003614074
Name:MATHEWS FAMILY PRACTICE PLLC
Entity type:Organization
Organization Name:MATHEWS FAMILY PRACTICE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN-CNP, PMHNP-BC
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-283-9746
Mailing Address - Street 1:PO BOX 175
Mailing Address - Street 2:
Mailing Address - City:CAVE CITY
Mailing Address - State:AR
Mailing Address - Zip Code:72521-0175
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:870-634-2098
Practice Address - Street 1:416 N MAIN ST STE F
Practice Address - Street 2:
Practice Address - City:CAVE CITY
Practice Address - State:AR
Practice Address - Zip Code:72521-9008
Practice Address - Country:US
Practice Address - Phone:870-283-9746
Practice Address - Fax:870-634-2098
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MATHEWS FAMILY PRACTICE PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-03-05
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty