Provider Demographics
NPI:1356513253
Name:MASON, PHILLIP ROSS (MD)
Entity type:Individual
Prefix:
First Name:PHILLIP
Middle Name:ROSS
Last Name:MASON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:4204 DOCTORS OFFICE TOWER
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:704-384-7840
Mailing Address - Fax:
Practice Address - Street 1:200 ROBINHOOD MEDICAL PLZ
Practice Address - Street 2:4204 DOCTORS OFFICE TOWER
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27106-5471
Practice Address - Country:US
Practice Address - Phone:336-718-7950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2021-08-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN51359207X00000X
NC2009-02020207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery