Massey, Kenneth R

Massey, Kenneth R is an individual health care provider with primary practice located at 2723 S 7Th Street Suite A, Terre Haute IN 47802-3558. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Massey, Kenneth R can be contacted via phone (812) 232-8164.

Contact Information

Primary practice address
2723 S 7Th Street Suite A Terre Haute IN 47802-3558
Phone: (812) 232-8164
Fax: (812) 234-6391
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 10000863A Indiana

Profile Details

NPI number 1073627691
LBN Legal business name Massey, Kenneth R
Credentials PAC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 19th, 2006
Last updated May 27th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073627691 NPPES
Indiana Other 650485596006 CHAMPUS-TRICARE

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