Eric G Massa
Foot & Ankle Surgery
39 Kent Rd Suite 9
Tifton
, Georgia 31794-1649
Eric G Massa
Foot & Ankle Surgery
39 Kent Rd Suite 9
Tifton
, Georgia 31794-1649
(912) 283-1618
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About
Features
Specialties
- Foot & Ankle Surgery
Languages spoken
- English
Location
First Address
- Eric G Massa
- 501 W Oneida St
- Waycross, GA
- Zip : 31501-5337
- Fax : (912) 283-1618
- Phone : (912) 283-7596
Second Address
- Eric G Massa
- 39 Kent Rd Suite 9
- Tifton, GA
- Zip : 31794-1649
- Fax : (229) 382-3247
- Phone : (229) 382-3338
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 213ES0103X | Foot & Ankle Surgery | POD001073 | GA |
National Provider Identifier
| NPI | 1043203920 |
|---|---|
| Provider Name | Eric G Massa |
| First Address | Waycross, GA 31501-5337 |
| Second Address | Tifton, GA 31794-1649 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/08/2005 |
| Last Update Date | 23/03/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 244934736A | (05) | GA |
| 52223803 | BLUE SHIELD (01) | |
| P00389076 | RAILROAD MEDICARE (01) | |
| U76515 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.