# MARY T CHAMPION

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1760779722
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 1 | KS | — |
| 207W00000X | Ophthalmology Physician | 50228 | AZ | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | 0439896 | KS | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | 2020013466 | MO | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | 50228 | AZ | — |

## Other

- **Enumeration date:** 06/28/2011
- **Last updated:** 12/11/2025