Provider Demographics
NPI:1104185834
Name:MASON, LILLIAN DARCY
Entity Type:Individual
Prefix:
First Name:LILLIAN
Middle Name:DARCY
Last Name:MASON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1208 DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-3342
Mailing Address - Country:US
Mailing Address - Phone:785-393-1709
Mailing Address - Fax:
Practice Address - Street 1:1208 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-3342
Practice Address - Country:US
Practice Address - Phone:785-393-1709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife