Provider Demographics
NPI:1598724130
Name:MASON, JOSHUA JOE (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:JOE
Last Name:MASON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N 29TH ST
Mailing Address - Street 2:
Mailing Address - City:FORT DODGE
Mailing Address - State:IA
Mailing Address - Zip Code:50501-2990
Mailing Address - Country:US
Mailing Address - Phone:515-227-7491
Mailing Address - Fax:888-594-7231
Practice Address - Street 1:20 N 29TH ST
Practice Address - Street 2:
Practice Address - City:FORT DODGE
Practice Address - State:IA
Practice Address - Zip Code:50501-2990
Practice Address - Country:US
Practice Address - Phone:515-227-7491
Practice Address - Fax:888-594-7231
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2018-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA06865111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0489245Medicaid
IA0486407Medicaid
IA0489245Medicaid
IAI17568Medicare ID - Type UnspecifiedGROUP NUMBER
IAI17569Medicare ID - Type UnspecifiedINDIVIDUAL