| Doctor Name: | ERIC G MASSA |
| NPI Number: | 1043203920 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | POD001073 |
| Business Practice Address: | 39 Kent Rd Suite 9 Tifton, GA - 317941649 |
| Business Phone Number: | 2293823338 |
| Business Fax Number: | 2293823247 |
| Mailing Address: | 501 W Oneida St, WAYCROSS |
| State: | GA |
| Postal Code: | 315015337 |
| Phone Number: | 9122837596 |
| Fax Number: | 9122831618 |
| NPI Enumeration Date: | 08/26/2005 |
| NPI Last Update Date: | 03/23/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | POD001073 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |