MEDICARE: MR. CURTIS TODD MASSEY RPH.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1200X	Pharmacotherapy Pharmacist	015771	GA

General Provider Information

NPI Number	:	1043213598
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. CURTIS TODD MASSEY RPH.

Provider Business Mailing Address
First Line	:	101 OCMULGEE SPRINGS DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31211-6353
Country	:	US
Telephone Number	:	478-731-2185
Fax Number	:	478-745-3264

Provider Business Practice Location Address
First Line	:	101 OCMULGEE SPRINGS DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31211-6353
Country	:	US
Telephone Number	:	478-731-2185
Fax Number	:	478-745-3264

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/28/2005
Last Update Date	:	07/08/2007

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