Individual
DR. WILLIAM TRENT MASSENGALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17503 OLD JEFFERSON HWY, PRAIRIEVILLE, LA 70769-3930
(225) 313-4560
(225) 673-3069
Mailing address
17503 OLD JEFFERSON HWY, PRAIRIEVILLE, LA 70769
(225) 313-4560
(225) 769-0471
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
023151
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1530000
—
LA
Enumeration date
10/05/2005
Last updated
08/22/2024
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