Provider Demographics
NPI:1104814656
Name:MASSEY, JAMES YOUNG (MD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:YOUNG
Last Name:MASSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1244 HIGHWAY 62-412
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-9468
Mailing Address - Country:US
Mailing Address - Phone:870-994-2737
Mailing Address - Fax:870-994-7111
Practice Address - Street 1:1244 HIGHWAY 62-412
Practice Address - Street 2:
Practice Address - City:HARDY
Practice Address - State:AR
Practice Address - Zip Code:72542-9468
Practice Address - Country:US
Practice Address - Phone:870-994-2737
Practice Address - Fax:870-994-7111
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-10
Last Update Date:2013-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR2008207Q00000X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR710680063OtherCHAMPUS TRICARE SOUTH
MO200065316Medicaid
AR1205270949OtherRELIEF CENTER, LLC GROUP NPI
AR180025519OtherRAILROAD MEDICARE
AR129897001Medicaid
AR0666740001OtherCIGNA GOVERNMENT SERVICES DMERC REGION C
AR1467533554OtherMASSEY EYE CLINIC GROUP NPI
AR1467533554OtherMASSEY EYE CLINIC GROUP NPI
AR129897001Medicaid
AR57181Medicare PIN
AR292765Medicare PIN