Healthcare Provider Details

I. General information

NPI: 1821433608
Provider Name (Legal Business Name): MASDON ENT & FACIAL PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 01/04/2024
Certification Date: 01/04/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ROWE DR STE B
GUNTERSVILLE AL
35976-7366
US

IV. Provider business mailing address

55 ROWE DR STE B
GUNTERSVILLE AL
35976-7366
US

V. Phone/Fax

Practice location:
  • Phone: 256-571-8450
  • Fax:
Mailing address:
  • Phone: 256-571-8450
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES MASDON
Title or Position: OWNER
Credential:
Phone: 256-571-8450