Healthcare Provider Details

I. General information

NPI: 1023807575
Provider Name (Legal Business Name): ABIGAIL ALBRITTON MASSEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 15TH ST # BP4109
AUGUSTA GA
30912-0004
US

IV. Provider business mailing address

1120 15TH ST # BP4109
AUGUSTA GA
30912-0006
US

V. Phone/Fax

Practice location:
  • Phone: 706-721-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number17534
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: