Provider Demographics
NPI:1174596472
Name:MASON, JOHN STEVEN (OD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STEVEN
Last Name:MASON
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:PO BOX 486
Mailing Address - Street 2:
Mailing Address - City:KENANSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28349-0486
Mailing Address - Country:US
Mailing Address - Phone:910-296-1781
Mailing Address - Fax:910-296-1843
Practice Address - Street 1:304 N MAIN ST
Practice Address - Street 2:DUPLIN EYE ASSOCIATES PA
Practice Address - City:KENANSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28349
Practice Address - Country:US
Practice Address - Phone:910-296-1781
Practice Address - Fax:910-296-1843
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2008-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1767152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890925XMedicaid
U78382Medicare UPIN
NC890925XMedicaid