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Individual

DR. STEPHEN PATRICK MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480
Mailing address
119 BOONE RIDGE DR, SUITE 201, JOHNSON CITY, TN 37615-4998
(423) 282-1480

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
29546
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
29546
STATE LICENSE
KY
Enumeration date
09/08/2006
Last updated
03/07/2023
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