Individual
SAMUEL O MASSEY III
Active
Individual
SAMUEL O MASSEY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31318
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100026452
PHP TNCARE
TN
05
—
1912956277
—
VA
01
—
300104374
RAILROAD MEDICARE
TN
01
—
3125936
BCBS
TN
05
—
3840825
—
TN
01
—
64017064
KENTUCKY MEDICAID
KY
01
—
7222238
VIRGINIA MEDICAID
VA
01
—
89063JF
NORTH CAROLINA MEDICAID
NC
05
—
Q007699
—
TN
Enumeration date
05/06/2006
Last updated
02/16/2017
Update your record
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