Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. MICHAEL LEROY MATTESON, PA C
ActiveMR. MICHAEL LEROY MATTESON, PA C is a Surgical Physician Assistant healthcare provider located in CARBONDALE, Illinois. NPI 1033386115 is currently active in the NPPES registry. Verify at CMS.
Surgical Physician Assistant · CARBONDALE, IL
Registration Details
- NPI Number
- 1033386115
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 8, 2008 (18.242578144709 yrs)
- Last Updated
- Dec 8, 2025
- Licenses
-
0110003884 (VA)385000710 (IL)
Practice Information
- Address
-
305 W JACKSON STSUITE 105CARBONDALE, IL, 629011474Browse IL providers · Browse ZIP 62901
- Phone
- 6185362565
- Fax
- 6185362835
- Primary Specialty
-
Surgical Physician Assistant
363AS0400X
- Additional Specialty
- Surgical Physician Assistant
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.