Provider Demographics
NPI:1134141484
Name:MASON, STEPHEN H (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:H
Last Name:MASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3633 CENTRAL AVE
Mailing Address - Street 2:SUITE N
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6475
Mailing Address - Country:US
Mailing Address - Phone:501-623-6100
Mailing Address - Fax:501-623-6187
Practice Address - Street 1:3633 CENTRAL AVE
Practice Address - Street 2:SUITE N
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6475
Practice Address - Country:US
Practice Address - Phone:501-623-6100
Practice Address - Fax:501-623-6187
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5877207ND0101X
KS0431916207ND0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARE5877OtherSTATE LICENSE
AR175507001Medicaid
AR175507001Medicaid