Organization
MEDICAL ASSOCIATES OF MASON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GREGORY W CARPENTER D.O. (CEO)
(513) 398-0015
Entity
Organization
Contact information
Practice address
666 READING RD, MASON, OH 45040-1575
(513) 398-0015
(315) 398-0025
Mailing address
666 READING RD, MASON, OH 45040-1575
(513) 398-0015
(315) 398-0025
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
004427
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000015629
ANTHEM
OH
05
—
2431550
—
OH
01
—
272487264001
MEDICAL MUTUAL
OH
01
—
4196743
AETNA
OH
01
—
CL5018
RAILROAD MEDICARE
OH
Enumeration date
08/11/2006
Last updated
10/23/2012
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