Healthcare Provider Details

I. General information

NPI: 1316960271
Provider Name (Legal Business Name): WILLIAM A MASSEY III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 PILOT MEDICAL DR SUITE 100
BIRMINGHAM AL
35235-3411
US

IV. Provider business mailing address

504 BROOKWOOD BLVD SUITE 100
BIRMINGHAM AL
35209-6802
US

V. Phone/Fax

Practice location:
  • Phone: 205-854-8084
  • Fax: 205-815-9341
Mailing address:
  • Phone: 205-871-9661
  • Fax: 205-870-1621

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number17948
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: