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General NPI Number Information
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NPI Number | 1063423390
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Entity Type | Organization
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Legal Business Name | MEDICAL ASSOCIATES OF MASON LLC
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 10/23/2012
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Provider Practice Location Address
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Address Line | 666 READING RD
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City | MASON
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State | OH
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Zip | 45040-1575
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Country | US
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Telephone | 513-398-0015
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Fax | 315-398-0025
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Provider Business Mailing Address
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Address Line | 666 READING RD
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City | MASON
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State | OH
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Zip | 45040-1575
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Country | US
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Telephone | 513-398-0015
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Fax | 315-398-0025
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Authorized Official
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Title or Position | CEO
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Name | GREGORY W CARPENTER
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Credential | D.O.
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Telephone | 513-398-0015
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 004427
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License Number State | OH
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