Individual
JESSICA SEBASTIAN VAN MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6734 LEE HWY, CHATTANOOGA, TN 37421-2423
(423) 899-0431
Mailing address
6734 LEE HWY, CHATTANOOGA, TN 37421-2423
(423) 899-0431
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
61122
TN
207K00000X
Allergy & Immunology Physician
85855
GA
208000000X
Pediatrics Physician
61122
TN
208000000X
Pediatrics Physician
85855
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/26/2015
Last updated
12/21/2020
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