Provider Demographics
NPI:1467878520
Name:SEELINGER, MASON CHARLES (OD)
Entity Type:Individual
Prefix:MR
First Name:MASON
Middle Name:CHARLES
Last Name:SEELINGER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 W 28TH AVE
Mailing Address - Street 2:
Mailing Address - City:PINE BLUFF
Mailing Address - State:AR
Mailing Address - Zip Code:71603-4774
Mailing Address - Country:US
Mailing Address - Phone:870-536-4100
Mailing Address - Fax:870-534-3982
Practice Address - Street 1:3805 W 28TH AVE
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-4774
Practice Address - Country:US
Practice Address - Phone:870-536-4100
Practice Address - Fax:870-534-3982
Is Sole Proprietor?:No
Enumeration Date:2014-03-13
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR2691152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
347043YTL2Medicare PIN