Healthcare Provider Details

I. General information

NPI: 1043213598
Provider Name (Legal Business Name): CURTIS TODD MASSEY RPH.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 OCMULGEE SPRINGS DR
MACON GA
31211-6353
US

IV. Provider business mailing address

101 OCMULGEE SPRINGS DR
MACON GA
31211-6353
US

V. Phone/Fax

Practice location:
  • Phone: 478-731-2185
  • Fax: 478-745-3264
Mailing address:
  • Phone: 478-731-2185
  • Fax: 478-745-3264

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number015771
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: