Individual
DR. PHYLLIS ELAINE MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
620 CROSSOVER ROAD, TUPELO, MS 38801-4944
(662) 620-7101
(662) 842-1457
Mailing address
PO BOX 830525, DEPT. #R24, BIRMINGHAM, AL 35283-0525
(662) 842-1758
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
06656
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009919405
—
AL
05
—
02284339
—
MS
01
—
300001102
MEDICARE
—
01
—
300138467
RAILROAD MEDICARE
MS
Enumeration date
06/13/2006
Last updated
10/09/2023
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