Provider Demographics
NPI:1992732721
Name:MASON, CYNTHIA R (MD)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:R
Last Name:MASON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-6264
Mailing Address - Country:US
Mailing Address - Phone:812-748-3412
Mailing Address - Fax:812-748-3413
Practice Address - Street 1:806 JACKSON ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-6264
Practice Address - Country:US
Practice Address - Phone:812-748-3412
Practice Address - Fax:812-748-3413
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038639207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
050322POtherSIHO
IN000000983635OtherANTHEM PIN
IN1790837789OtherGROUP NPI
IN100384020Medicaid
IN000000180845OtherANTHEM
INP00303504OtherMEDICARE RAILROAD
E50950Medicare UPIN
IN1790837789OtherGROUP NPI
IN100384020Medicaid