Healthcare Provider Details

I. General information

NPI: 1043244650
Provider Name (Legal Business Name): DAVID MASON PHD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 FRANCIS PL SUITE 200
CLAYTON MO
63105-2465
US

IV. Provider business mailing address

950 FRANCIS PL SUITE 200
CLAYTON MO
63105-2465
US

V. Phone/Fax

Practice location:
  • Phone: 314-725-2686
  • Fax: 314-725-2680
Mailing address:
  • Phone: 314-725-2686
  • Fax: 314-725-2680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number01496
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number201191
License Number StateMO

VIII. Authorized Official

Name: DAVID I MASON
Title or Position: PRESIDENT
Credential: PHD
Phone: 314-725-2686