NPI 1154642015

Gordon B Massengale a Medical Corp

Organisation Family Medicine Physician Rayville, LA

Practice location

Address: 111 Christian Dr, Rayville, LA 71269-3658
Phone: (318) 728-3263
Fax: (318) 728-3095
Mailing address: PO Box 960, Rayville, LA 71269-0960

Authorised official

Name: Gordon B Massengale
Title: President
Phone: (318) 728-3263

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X Licence 012197 (LA)

Other Family Medicine providers in Louisiana →

Registry record

NPI: 1154642015
Entity type: Organization
NPI issued: 15 Jun 2010
Record last updated: 15 Jun 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.