Provider Demographics
NPI:1497109912
Name:MASSENGILL, BRITTANY T (MD)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:T
Last Name:MASSENGILL
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 1:1948 AL HIGHWAY 157 STE 330
Mailing Address - Street 2:
Mailing Address - City:CULLMAN
Mailing Address - State:AL
Mailing Address - Zip Code:35058-0643
Mailing Address - Country:US
Mailing Address - Phone:256-735-5277
Mailing Address - Fax:256-203-8626
Practice Address - Street 1:1948 AL HIGHWAY 157 STE 330
Practice Address - Street 2:
Practice Address - City:CULLMAN
Practice Address - State:AL
Practice Address - Zip Code:35058-0643
Practice Address - Country:US
Practice Address - Phone:256-735-5277
Practice Address - Fax:256-203-8626
Is Sole Proprietor?:No
Enumeration Date:2016-04-21
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.39389207V00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL250056Medicaid