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General NPI Number Information
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NPI Number | 1427094549
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Entity Type | Individual
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Provider Name | KEVIN D MASON MD
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Gender | Male
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Dates
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Enumeration Date | 06/20/2006
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Last Update Date | 10/03/2018
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Provider Practice Location Address
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Address Line | 1405 FRANKLIN RD SE
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City | MARIETTA
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State | GA
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Zip | 30067-8721
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Country | US
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Telephone | 770-951-5400
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Fax | 770-951-5408
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Provider Business Mailing Address
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Address Line | 720 WESTVIEW DR SW
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City | ATLANTA
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State | GA
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Zip | 30310-1458
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Country | US
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Telephone | 770-951-5400
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Fax | 770-951-5408
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 028604
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License Number State | GA
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