Provider Demographics
NPI:1710387113
Name:MASDON ENT & FACIAL PLASTIC SURGERY LLC
Entity Type:Organization
Organization Name:MASDON ENT & FACIAL PLASTIC SURGERY LLC
Other - Org Name:MASDON ENT HEARING AIDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-571-8450
Mailing Address - Street 1:55 ROWE DR STE B
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-7366
Mailing Address - Country:US
Mailing Address - Phone:256-571-8450
Mailing Address - Fax:256-571-8450
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:256-571-8450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologistGroup - Single Specialty