Provider Demographics
NPI:1427027770
Name:MASON, CHARLES W (DO)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:W
Last Name:MASON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:8530 NORTHBLUFF LN
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-8084
Mailing Address - Country:US
Mailing Address - Phone:740-881-9190
Mailing Address - Fax:614-451-2291
Practice Address - Street 1:8530 NORTHBLUFF LN
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:OH
Practice Address - Zip Code:43065-8084
Practice Address - Country:US
Practice Address - Phone:740-881-9190
Practice Address - Fax:614-451-2291
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-01-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH34002034207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0198610Medicaid
OH0372298Medicare ID - Type UnspecifiedOHIO MEDICARE
OHF06589Medicare UPIN