Individual
VICKI LEE MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 E CHESTNUT ST, LOUISVILLE, KY 40202-1831
(502) 629-6000
Mailing address
PO BOX 76879, CHICAGO, IL 60677-6879
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
207LP3000X
Pediatric Anesthesiology Physician
26424
KY
208000000X
Pediatrics Physician
26424
KY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
26424
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100374690A
—
IN
05
—
64264245
—
KY
Enumeration date
11/30/2005
Last updated
10/26/2020
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