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NPI Code Detail

MEDICARE: DEBORAH SMITH MASON PT

MEDICARE: DEBORAH SMITH MASON PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist1818OK

General Provider Information

NPI Number : 1134193972
Entity Type Code : Individual
Provider Name (Legal Business Name) : DEBORAH SMITH MASON PT
Provider Business Mailing Address
First Line : 9600 BROADWAY EXT
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73114-7408
Country : US
Telephone Number : 405-230-9000
Fax Number : 405-230-9175
Provider Business Practice Location Address
First Line : 3700 36TH AVE NW
Second Line :
City : NORMAN
State : OK
Zip : 73072-1803
Country : US
Telephone Number : 405-230-9675
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 08/09/2019

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Directions to “ DEBORAH SMITH MASON PT” Practice Location

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