Organization

W Trent Massengale, Md Llc

Dermatology Physician in Prairieville, LA(View on Map)

Legal Business Name

W Trent Massengale, Md Llc

NPI Number

1255774287

NPI Type

Organization

Enumeration Date

04/09/2013

Specialties

(Taxonomies)

Code

207N00000X

Primary Taxonomy

Yes

Contact
Information

Purpose

Mailing
Location

Address

17503 OLD JEFFERSON HWY
17503 OLD JEFFERSON HWY

City

Prairieville
Prairieville

State

LA
LA

Postal Code

70769-3930
70769-3930

Country

US
US

Telephone Number

(225) 313-4560
(225) 313-4560

Authorized Official

Name

William Massengale

Title or Position

DERMATOLOGIST

Telephone Number

(225) 769-7546

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 08/22/2024

Provider Address