Individual
DAVID MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
502 W SAINT LOUIS ST STE 4, WEST FRANKFORT, IL 62896-1968
(618) 937-3400
(618) 997-9324
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085002553
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
85002553
ILLINOIS LICENSE
IL
Enumeration date
06/07/2006
Last updated
01/29/2021
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