Provider Demographics
NPI:1902041270
Name:MASON EYE CENTER, INC.
Entity Type:Organization
Organization Name:MASON EYE CENTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TED
Authorized Official - Middle Name:
Authorized Official - Last Name:SNYDER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:513-770-4220
Mailing Address - Street 1:7567 CENTRAL PARKE BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6852
Mailing Address - Country:US
Mailing Address - Phone:513-770-4220
Mailing Address - Fax:513-770-4120
Practice Address - Street 1:7567 CENTRAL PARKE BLVD
Practice Address - Street 2:SUITE C
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6852
Practice Address - Country:US
Practice Address - Phone:513-770-4220
Practice Address - Fax:513-770-4120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-15
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHT4147152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH6258860001Medicare NSC
9382311Medicare PIN