Healthcare Provider Details

I. General information

NPI: 1417138355
Provider Name (Legal Business Name): MASSEY HAND AND PLASTIC SURGERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2007
Last Update Date: 04/07/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3170 N SWAN RD
TUCSON AZ
85712-1227
US

IV. Provider business mailing address

1951 N WILMOT RD BLDG 2
TUCSON AZ
85712-8000
US

V. Phone/Fax

Practice location:
  • Phone: 520-298-2325
  • Fax:
Mailing address:
  • Phone: 520-750-7166
  • Fax: 520-886-1929

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number35576
License Number StateAZ

VIII. Authorized Official

Name: DR. BRANDON ZELPH MASSEY
Title or Position: OWNER
Credential: MD
Phone: 520-298-2325