Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | J0098 | TX |
N | 207X00000X | Orthopaedic Surgeon | MD0000031271 | TN |
NPI | 1033180922 |
---|---|
Provider Name | John Patrick Masterson |
First Address | Brownwood, TX 76801-5902 |
Second Address | Jackson, TN 38301-3931 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2006 |
Last Update Date | 05/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3841246 | (05) | TN |
G92677 | (02) | TN |