Individual
MASON PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6965 CUMBERLAND GAP PKWY, HARROGATE, TN 37752-8231
(423) 869-3611
Mailing address
2017 VAIL DR, GARLAND, TX 75044-6790
(468) 888-3048
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4050471
KY
Other
Enumeration date
06/20/2023
Last updated
12/19/2025
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