Organization
MARION COUNTY ANESTHESIA ASSOCIATES PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES ADAM MONTGOMERY M.D. (PRESIDENT)
(859) 268-1030
Entity
Organization
Contact information
Practice address
320 LORETTO ROAD, LEBANON, KY 40033
(270) 692-3161
Mailing address
PO BOX 23745, LEXINGTON, KY 40523-3745
(859) 268-1030
(859) 269-4120
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
65942724
—
KY
05
—
74900887
—
KY
Enumeration date
10/04/2006
Last updated
06/28/2011
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