MEDICARE: DR. ROBERT J MASSINGILL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	011260	LA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1770587461
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT J MASSINGILL MD

Provider Business Mailing Address
First Line	:	919 HIDDEN RDG
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-3813
Country	:	US
Telephone Number	:	469-282-2711
Fax Number	:	469-282-0996

Provider Business Practice Location Address
First Line	:	2539 VIKING DR
Second Line	:
City	:	BOSSIER CITY
State	:	LA
Zip	:	71111-1611
Country	:	US
Telephone Number	:	318-848-2970
Fax Number	:	318-848-2971

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	11/14/2016

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