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Individual
DR. AUDREY K MONTOOTH
Active
Individual
DR. AUDREY K MONTOOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
113043
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000013907
ESSENCE
MO
01
—
0102099
UHC
MO
05
—
205163207
—
MO
01
—
210862
BCBS
MO
01
—
290148
GHP
MO
01
—
438069
HEALTHLINK
MO
01
—
752695810MON
MERCY
MO
Enumeration date
05/18/2006
Last updated
10/03/2012
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