Individual
ERIC G MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
39 KENT RD, SUITE 9, TIFTON, GA 31794-1649
(229) 382-3338
(229) 382-3247
Mailing address
501 W ONEIDA ST, WAYCROSS, GA 31501-5337
(912) 283-7596
(912) 283-1618
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD001073
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
244934736A
—
GA
01
—
52223803
BLUE SHIELD
—
01
—
P00389076
RAILROAD MEDICARE
—
Enumeration date
08/26/2005
Last updated
03/23/2010
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