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General NPI Number Information
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NPI Number | 1255392148
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Entity Type | Individual
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Provider Name | TINA MARIE MASON MD
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Gender | Female
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Dates
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Enumeration Date | 03/30/2006
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 6300 HOSPITAL PKWY SUITE 200
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City | JOHNS CREEK
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State | GA
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Zip | 30097-1828
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Country | US
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Telephone | 678-985-5800
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Fax | 678-376-5848
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Provider Business Mailing Address
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Address Line | 6300 HOSPITAL PKWY SUITE 200
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City | JOHNS CREEK
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State | GA
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Zip | 30097-1828
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Country | US
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Telephone | 678-985-5800
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Fax | 678-376-5848
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 039405
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License Number State | GA
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