Provider Demographics
NPI:1962878165
Name:MASSEY, DAVID SCOTT
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:MASSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5989 HIGHWAY 4 W
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-3714
Mailing Address - Country:US
Mailing Address - Phone:662-560-6034
Mailing Address - Fax:662-562-0284
Practice Address - Street 1:5989 HIGHWAY 4 W
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-3714
Practice Address - Country:US
Practice Address - Phone:662-560-6034
Practice Address - Fax:662-562-0284
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-11
Last Update Date:2015-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion