Provider Demographics
NPI:1699771303
Name:MASON, GAYLE L (MD)
Entity type:Individual
Prefix:DR
First Name:GAYLE
Middle Name:L
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3400 C OLD MILTON PARKWAY
Mailing Address - Street 2:STE 425
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005
Mailing Address - Country:US
Mailing Address - Phone:770-343-8760
Mailing Address - Fax:770-664-2101
Practice Address - Street 1:3400 C OLD MILTON PARKWAY
Practice Address - Street 2:STE 425
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005
Practice Address - Country:US
Practice Address - Phone:770-343-8760
Practice Address - Fax:770-664-2101
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2016-11-21
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Provider Licenses
StateLicense IDTaxonomies
GA023388207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00259355EMedicaid
GA29BDBZLMedicare PIN
GA00259355EMedicaid