Provider Demographics
NPI:1891865135
Name:MASSEY, NATHAN HEFLIN (MD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:HEFLIN
Last Name:MASSEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 WILHITE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3385
Mailing Address - Country:US
Mailing Address - Phone:859-278-6031
Mailing Address - Fax:859-277-7015
Practice Address - Street 1:2620 WILHITE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3385
Practice Address - Country:US
Practice Address - Phone:859-278-6031
Practice Address - Fax:859-277-7015
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34945207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64060999Medicaid
KY64060999Medicaid
H66387Medicare UPIN