Massengill, Jason Carlisle

Massengill, Jason Carlisle is an individual health care provider with primary practice located at 4881 Sugar Maple Dr , Wright Patterson Afb OH 45433-5529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Massengill, Jason Carlisle can be contacted via phone (937) 257-1941.

Contact Information

Primary practice address
4881 Sugar Maple Dr Wright Patterson Afb OH 45433-5529
Phone: (937) 257-1941
Fax: (937) 257-3012
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 01060945A Indiana
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 122570 Ohio

Profile Details

NPI number 1134263338
LBN Legal business name Massengill, Jason Carlisle
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 19th, 2007
Last updated Feb 8th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134263338 NPPES
Ohio MEDICAID 0117005

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