Individual
MASON JAY STICKNEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
250 NORTH CASWELL ROAD, SUITE 200A, CHARLOTTE, NC 28207
(704) 323-2564
Mailing address
500 HEALTH SCIENCE DRIVE, GREENVILLE, NC 27834
(252) 744-1100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
NC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
11/01/2024
Last updated
04/13/2026
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