Individual
DR. SAMUEL SCOTT MASSINGILL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1710 14TH ST, MERIDIAN, MS 39301-4140
(601) 482-9211
(601) 482-9497
Mailing address
PO BOX 5183, MERIDIAN, MS 39302-5183
(601) 703-9506
(601) 703-3264
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12140
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00115812
—
MS
01
—
730-70723
BLUE CROSS OF AL
—
Enumeration date
11/16/2005
Last updated
07/08/2007
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