Individual
DR. JASON CARLISLE MASSENGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-1941
(937) 257-3012
Mailing address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
(937) 257-1941
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
01060945A
IN
207V00000X
Obstetrics & Gynecology Physician
Primary
122570
OH
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
35.122570
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0117005
—
OH
Enumeration date
02/19/2007
Last updated
12/02/2025
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