Provider Demographics
NPI:1407857394
Name:MASSONY, BARBARA N (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:N
Last Name:MASSONY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 15TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2524
Mailing Address - Country:US
Mailing Address - Phone:228-864-4392
Mailing Address - Fax:228-868-7103
Practice Address - Street 1:4320 15TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2524
Practice Address - Country:US
Practice Address - Phone:228-864-4392
Practice Address - Fax:228-868-7103
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSB620382085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00115057Medicaid
MSB62038Medicare UPIN