Provider Demographics
NPI:1003224247
Name:MASON, HUNTER I
Entity Type:Individual
Prefix:MR
First Name:HUNTER
Middle Name:
Last Name:MASON
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 HARTSFIELD DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-4813
Mailing Address - Country:US
Mailing Address - Phone:501-278-9904
Mailing Address - Fax:501-278-9906
Practice Address - Street 1:411 HARTSFIELD DR
Practice Address - Street 2:
Practice Address - City:SEARCY
Practice Address - State:AR
Practice Address - Zip Code:72143-4813
Practice Address - Country:US
Practice Address - Phone:501-278-9904
Practice Address - Fax:501-278-9906
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3856174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty