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General NPI Number Information
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NPI Number | 1487312302
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Entity Type | Organization
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Legal Business Name | GAYLE P MASTERSON, MD, PLC
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 6280 E PIMA ST STE 110
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City | TUCSON
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State | AZ
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Zip | 85712-3074
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Country | US
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Telephone | 520-229-0585
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Fax |
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Provider Business Mailing Address
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Address Line | 6280 E PIMA ST STE 110
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City | TUCSON
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State | AZ
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Zip | 85712-3074
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Country | US
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Telephone | 520-229-0585
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Fax |
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Authorized Official
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Title or Position | MEMBER OF LLC, OWNER, PHYSICIAN
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Name | DR. GAYLEQ P MASTERSON
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Credential | MD
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Telephone | 520-229-0585
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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