Provider Demographics
NPI:1477892578
Name:MASSEY, CLAYTON WHIT
Entity Type:Individual
Prefix:MR
First Name:CLAYTON
Middle Name:WHIT
Last Name:MASSEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7245 DOSS DR
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-1909
Mailing Address - Country:US
Mailing Address - Phone:229-382-5126
Mailing Address - Fax:
Practice Address - Street 1:7245 DOSS DR
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31794-1909
Practice Address - Country:US
Practice Address - Phone:229-382-5126
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-08
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver