Healthcare Provider Details

I. General information

NPI: 1235343773
Provider Name (Legal Business Name): KATHERINE ANNA MASON ALVORD M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KATHERINE ANNA MASON M.D.

II. Dates (important events)

Enumeration Date: 05/10/2007
Last Update Date: 01/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 WASHINGTON AVE SUITE 410
MEMPHIS TN
38105-4550
US

IV. Provider business mailing address

3845 WAYNOKA AVE
MEMPHIS TN
38111-6920
US

V. Phone/Fax

Practice location:
  • Phone: 901-523-2945
  • Fax:
Mailing address:
  • Phone: 901-683-4541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number45110
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: