Provider Demographics
NPI:1841385549
Name:MASON, JAMES W (OD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:MASON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:180 E BROAD ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7573
Mailing Address - Country:US
Mailing Address - Phone:740-927-3061
Mailing Address - Fax:740-927-7042
Practice Address - Street 1:180 E BROAD ST
Practice Address - Street 2:SUITE A
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7573
Practice Address - Country:US
Practice Address - Phone:740-927-3061
Practice Address - Fax:740-927-7042
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3134T947152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T46760Medicare UPIN
OH0767980001Medicare NSC
MA0416382Medicare ID - Type Unspecified