Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VE0102X | Reproductive Endocrinologist | 012110 | GA |
NPI | 1275593394 |
---|---|
Provider Name | Joe B Massey |
First Address | Atlanta, GA 30342-1522 |
Second Address | Atlanta, GA 30342-1522 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2006 |
Last Update Date | 27/05/2008 |