Provider Demographics
NPI:1235356403
Name:MASON, SHARRON M (MD)
Entity Type:Individual
Prefix:
First Name:SHARRON
Middle Name:M
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 OUACHITA AVE
Mailing Address - Street 2:SUITE 310 C. BOX 26
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-5167
Mailing Address - Country:US
Mailing Address - Phone:501-463-9079
Mailing Address - Fax:501-463-7080
Practice Address - Street 1:320 OUACHITA AVE
Practice Address - Street 2:SUITE 310 C. BOX 26
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-5167
Practice Address - Country:US
Practice Address - Phone:501-463-9079
Practice Address - Fax:501-463-7080
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2014-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS946601207R00000X
ARE5946207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
5H850F484Medicare UPIN