Individual
DR. DEAN PARKER MONTGOMERY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D
Contact information
Practice address
100 W 7TH ST, OKMULGEE, OK 74447-5007
(918) 758-1910
(918) 756-1270
Mailing address
PO BOX 471556, TULSA, OK 74147-1556
(918) 250-6805
(918) 250-2084
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
575
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100840530A
—
OK
01
—
731229233002
BLUE CROSS BLUE SHIELD
OK
Enumeration date
10/04/2006
Last updated
07/16/2007
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