Organization
MASSEY CLINIC LTD
Active
Parent organization
MASSEY CLINIC LTD
Other names
Massey Clinic LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
MASSEY CLINIC LTD
Authorized official
DR. WILLIAM JOSEPH MASSEY III MD (PRESIDENT)
(757) 229-0919
Entity
Organization
Contact information
Practice address
322 MONTICELLO AVE, WILLIAMSBURG, VA 23185-2834
(757) 229-0919
(757) 229-0927
Mailing address
322 MONTICELLO AVE, WILLIAMSBURG, VA 23185-2834
(757) 229-0919
(757) 229-0927
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
18861
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
015815
ANTHEM BCBS
VA
01
—
1467567537
GROUP NPI
VA
01
—
C10955
GROUP PTAN
VA
Enumeration date
08/20/2006
Last updated
03/29/2010
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