Healthcare Provider Details

I. General information

NPI: 1124192943
Provider Name (Legal Business Name): BENJAMIN H MASSEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7301 N 16TH ST STE 102
PHOENIX AZ
85020-5266
US

IV. Provider business mailing address

PO BOX 9416
PUEBLO CO
81008-9416
US

V. Phone/Fax

Practice location:
  • Phone: 480-420-4027
  • Fax:
Mailing address:
  • Phone: 719-546-0557
  • Fax: 719-546-0557

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number67448
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberCDRH.0025593
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number25593
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: