| Doctor Name: | DR. VICTOR P. MATIBAG |
| NPI Number: | 1265433023 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 23576 |
| Business Practice Address: | 1035 Wall St Suite 207 Jeffersonville, IN - 471303612 |
| Business Phone Number: | 8122821351 |
| Business Fax Number: | 8122835758 |
| Mailing Address: | 1035 Wall St, Suite 207 JEFFERSONVILLE |
| State: | IN |
| Postal Code: | 471303612 |
| Phone Number: | 8122821351 |
| Fax Number: | 8122835758 |
| NPI Enumeration Date: | 08/02/2005 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 03/21/2006 |
| NPI Reactivation Date: | 03/29/2006 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 23576 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |