Provider Demographics
NPI:1558576439
Name:MASON, DARAN JENNINGS (MD)
Entity Type:Individual
Prefix:DR
First Name:DARAN
Middle Name:JENNINGS
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 1:3715 DAUPHIN ST
Mailing Address - Street 2:BLDG 2, SUITE 7-B
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1771
Mailing Address - Country:US
Mailing Address - Phone:251-340-7880
Mailing Address - Fax:251-340-7881
Practice Address - Street 1:3715 DAUPHIN ST
Practice Address - Street 2:BLDG 2, SUITE 7-B
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1771
Practice Address - Country:US
Practice Address - Phone:251-340-7880
Practice Address - Fax:251-340-7881
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-13
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL29026208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery