Individual
LEONARD DARNELL MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8100
Mailing address
1850 TOWN CENTER PKWY STE 309, RESTON, VA 20190-3300
(703) 705-4180
(571) 926-8943
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
8573
GA
363A00000X
Physician Assistant
12181
MN
363A00000X
Physician Assistant
C0007177
MD
363AS0400X
Surgical Physician Assistant
6155
AZ
Other
Enumeration date
09/24/2015
Last updated
01/31/2024
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