Provider Demographics
NPI:1295848471
Name:MASDON, JAMES L (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:MASDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:L
Other - Last Name:MASDON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:602 CORLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOAZ
Mailing Address - State:AL
Mailing Address - Zip Code:35957-5952
Mailing Address - Country:US
Mailing Address - Phone:256-571-8450
Mailing Address - Fax:256-840-4584
Practice Address - Street 1:55 ROWE DR STE B
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-7366
Practice Address - Country:US
Practice Address - Phone:256-571-8450
Practice Address - Fax:256-840-4584
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00023577207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-35385OtherBCBS OF ALABAMA
AL515-35385OtherBCBS OF ALABAMA