Individual
DR. JUSTIN ROYSE MONTGOMERY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 ROSE ST, HX304, LEXINGTON, KY 40536-0001
(859) 323-5069
Mailing address
800 ROSE ST, HX304, LEXINGTON, KY 40536-0001
(859) 323-5291
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
44342
KY
2085R0202X
Diagnostic Radiology Physician
Primary
44342
KY
2085R0202X
Diagnostic Radiology Physician
R1490
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100218400
—
KY
Enumeration date
07/28/2008
Last updated
12/19/2012
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