Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A97978 | CA |
N | 207VE0102X | Reproductive Endocrinologist | A97978 | CA |
NPI | 1255403622 |
---|---|
Provider Name | Dr. Jamie Ann Mckeehan Massie |
First Address | Fort Sam Houston, TX 78234-4504 |
Second Address | Fort Sam Houston, TX 78234-4504 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/11/2006 |
Last Update Date | 15/05/2015 |