Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 35576 | AZ |
Y | 208600000X | Surgeon | 35576 | AZ |
N | 2086S0105X | Surgery of the Hand | 35576 | AZ |
NPI | 1356362545 |
---|---|
Provider Name | Dr. Brandon Z Massey |
First Address | Tucson, AZ 85732-3627 |
Second Address | Tucson, AZ 85711-1843 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/07/2006 |
Last Update Date | 19/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
115539 | (05) | AZ |