Individual
JEREMY M MASON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
10229 E 96TH ST N SUITE 101, OWASSO, OK 74055
(918) 272-8920
(918) 272-8922
Mailing address
701 W. ELGIN ST, BROKEN ARROW, OK 74012
(918) 455-2001
(918) 301-0088
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
256
OK
213ES0103X
Foot & Ankle Surgery Podiatrist
00256
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00256
OKLAHOMA LICENSE NUMBER
OK
Enumeration date
05/13/2008
Last updated
11/29/2023
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