MEDICARE: DR. REGINALD N. MASON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	23793	AL

General Provider Information

NPI Number	:	1215944566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. REGINALD N. MASON M.D.

Provider Business Mailing Address
First Line	:	96 ALI WAY
Second Line	:	CREEKSIDE S.
City	:	ANNISTON
State	:	AL
Zip	:	36203-1835
Country	:	US
Telephone Number	:	205-369-3156
Fax Number	:	256-832-4153

Provider Business Practice Location Address
First Line	:	96 ALI WAY
Second Line	:	CREEKSIDE S.
City	:	ANNISTON
State	:	AL
Zip	:	36203-1835
Country	:	US
Telephone Number	:	205-369-3156
Fax Number	:	256-832-4153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	07/08/2007

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