Individual
THOMAS PAYNE MASSELLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
JAMES H. QUILLEN/VAMC, CORNER OF SIDNEY AND LAMONT (JOHNSON CITY), MOUNTAIN HOME, TN 37684-4000
(423) 979-2734
(423) 979-2696
Mailing address
111 LAKE HARBOR DR, JOHNSON CITY, TN 37615-2972
(423) 477-8258
(501) 644-5818
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
08553
MS
Other
Enumeration date
07/03/2006
Last updated
07/08/2007
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