Individual
DR. JOHN L. MASON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
141 WILDEWOOD PARK DR, COLUMBIA, SC 29223-4300
(803) 865-5522
(803) 865-5496
Mailing address
141 WILDEWOOD PARK DR, COLUMBIA, SC 29223-4300
(803) 865-5520
(803) 865-5496
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1186
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
D11869
—
SC
05
—
DA9757
—
SC
05
—
DA9816
—
SC
Enumeration date
11/11/2005
Last updated
10/31/2011
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