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Individual

DR. TIMOTHY J. MASON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
9390 E CENTRAL AVE, STE 101, WICHITA, KS 67206-2555
(316) 636-2080
(316) 636-2965
Mailing address
9390 E CENTRAL AVE, STE 101, WICHITA, KS 67206-2555
(316) 636-2080
(316) 636-2965

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1659
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0191040001
MEDICARE NSC
KS
05
200000160A
KS
05
200000160E
KS
01
201552
HEALTH PARTNERS OF KS
KS
01
462314
HEALTHWAVE
KS
01
468501
CHILDREN'S MERCY/FHP
KS
01
651172
BCBS
KS
01
7304
PREFERRED HEALTHE SYSTEMS
KS
01
P00467868
RR MEDICARE PIN
KS
Enumeration date
07/08/2005
Last updated
10/11/2012
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