Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 1958 | AL |
N | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 1958 | AL |
NPI | 1487073649 |
---|---|
Provider Name | Caleb Masterson |
First Address | Florence, AL 35631-2005 |
Second Address | Florence, AL 35630-2727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2014 |
Last Update Date | 29/07/2019 |