Provider Demographics
NPI:1942270186
Name:MASON, DONALD ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:ROBERT
Last Name:MASON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:505 DEER POINT DR
Mailing Address - Street 2:
Mailing Address - City:GULF BREEZE
Mailing Address - State:FL
Mailing Address - Zip Code:32561-4536
Mailing Address - Country:US
Mailing Address - Phone:850-505-6372
Mailing Address - Fax:850-505-6607
Practice Address - Street 1:6715 W HIGHWAY 98
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32506-5923
Practice Address - Country:US
Practice Address - Phone:850-453-6737
Practice Address - Fax:850-458-9935
Is Sole Proprietor?:No
Enumeration Date:2006-01-23
Last Update Date:2013-01-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME48817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL258841200Medicaid
FL46381OtherBCBSFL
AL593-09694OtherBCBSAL
FL258841200Medicaid