Provider Demographics
NPI:1124635933
Name:MASON J CARP MD
Entity type:Organization
Organization Name:MASON J CARP MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MASON
Authorized Official - Middle Name:J
Authorized Official - Last Name:CARP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-370-0810
Mailing Address - Street 1:4212 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-1025
Mailing Address - Country:US
Mailing Address - Phone:717-657-7025
Mailing Address - Fax:301-774-0505
Practice Address - Street 1:4212 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-1025
Practice Address - Country:US
Practice Address - Phone:717-657-7025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-25
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty