Healthcare Provider Details

I. General information

NPI: 1154700011
Provider Name (Legal Business Name): SCOTT MASSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2015
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W CHURCH ST STE 101
JASPER GA
30143-1618
US

IV. Provider business mailing address

3390 PEACHTREE RD NE STE 1500
ATLANTA GA
30326-2822
US

V. Phone/Fax

Practice location:
  • Phone: 770-929-9033
  • Fax: 770-929-9092
Mailing address:
  • Phone: 770-929-9033
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number5101025390
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number86021
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number003234274U
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: