Healthcare Provider Details

I. General information

NPI: 1972291367
Provider Name (Legal Business Name): DR. MASON CARTER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17171 S GOLDEN RD
GOLDEN CO
80401-7334
US

IV. Provider business mailing address

17171 S GOLDEN RD
GOLDEN CO
80401-7334
US

V. Phone/Fax

Practice location:
  • Phone: 303-279-5684
  • Fax:
Mailing address:
  • Phone: 303-279-5684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number20035
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number25537
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPHA.0025537
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: