MEDICARE: BRIAN PATRICK MASON MD

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	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	41460	GA
2	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	041460	GA

General Provider Information

NPI Number	:	1821196866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN PATRICK MASON MD

Provider Business Mailing Address
First Line	:	3495 PIEDMONT RD NE
Second Line	:	NINE PEIDMONT CENTER
City	:	ATLANTA
State	:	GA
Zip	:	30305-1717
Country	:	US
Telephone Number	:	404-364-7070
Fax Number	:	770-994-9326

Provider Business Practice Location Address
First Line	:	750 TOWNPARK LN NW
Second Line	:	TOWN PARK COMPREHENSIVE MEDICAL CENTER
City	:	KENNESAW
State	:	GA
Zip	:	30144-5579
Country	:	US
Telephone Number	:	404-365-0966
Fax Number	:	770-994-4747

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

Provider Enumeration Date	:	09/21/2006
Last Update Date	:	01/13/2022

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