Individual
DR. VIRGIL R. MASSEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1808 W MAIN ST, RUSSELLVILLE, AR 72801-2724
(479) 968-2841
Mailing address
PO BOX 1351, RUSSELLVILLE, AR 72811-1351
(800) 235-1415
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
C8375
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050030511
RR MEDICARE GROUP CC5970
—
05
—
123440001
—
AR
01
—
5J132
BLUE CROSS BLUE SHIELD AR
AR
01
—
770078001
AR BREASTCARE
AR
Enumeration date
08/02/2005
Last updated
11/19/2009
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