Mason, John L.

Mason, John L. is an sole proprietor health care provider with primary practice located at 141 Wildewood Park Dr , Columbia SC 29223-4300. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Mason, John L. can be contacted via phone (803) 865-5522.

Contact Information

Primary practice address
141 Wildewood Park Dr Columbia SC 29223-4300
Phone: (803) 865-5522
Fax: (803) 865-5496
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 1186 South Carolina

Profile Details

NPI number 1134100530
LBN Legal business name Mason, John L.
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 11th, 2005
Last updated Oct 31st, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134100530 NPPES
South Carolina MEDICAID D11869
South Carolina MEDICAID DA9757
South Carolina MEDICAID DA9816

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