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NPI Code Detail

MEDICARE: TINA C MASON MD

MEDICARE: TINA C MASON MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician131892CA
2207V00000XObstetrics & Gynecology Physician01087047AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1131892OTHERCALICENSE

General Provider Information

NPI Number : 1457301301
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA C MASON MD
Provider Business Mailing Address
First Line : 8414 NAAB RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1972
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8414 NAAB RD
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46260-1972
Country : US
Telephone Number : 317-338-7510
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/11/2006
Last Update Date : 01/23/2026

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