Basic Information
| Provider Information | |||||||||
| NPI: | 1306878764 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MASON | ||||||||
| FirstName: | ROY | ||||||||
| MiddleName: | CARRINGTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1000 36TH ST | ||||||||
| Address2: | |||||||||
| City: | VERO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 329604862 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7725674311 | ||||||||
| FaxNumber: | 7725634641 | ||||||||
| Practice Location | |||||||||
| Address1: | 3450 11TH CT STE 303 | ||||||||
| Address2: | |||||||||
| City: | VERO BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 32960 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7727949771 | ||||||||
| FaxNumber: | 7727949773 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/07/2006 | ||||||||
| LastUpdateDate: | 08/30/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208800000X | OS15210 | FL | Y | Allopathic & Osteopathic Physicians | Urology |
ID Information
| ID | Type | State | Issuer | Description | 340013731 | 01 | TX | RAIL ROAD MEDICARE | OTHER | 001465497 | 01 | TX | UNITED HEALTH | OTHER | 122060004 | 05 | TX | MEDICAID | 122060005 | 05 | TX | MEDICAID | 8301777005 | 01 | TX | CIGNA | OTHER | 8A9484 | 01 | TX | BLUECROSS BLUESHIELD | OTHER | 0957950 | 01 | TX | AETNA | OTHER | 122060006 | 05 | TX | MEDICAID |