Individual
DR. SAMUEL JACOB MONTGOMERY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22995 US HIGHWAY 76, CLINTON, SC 29325-7529
(864) 654-6706
Mailing address
PO BOX 11407, BIRMINGHAM, AL 35246-8575
(864) 359-1308
(239) 496-3939
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
20855
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180045119
RAILROAD MEDICARE
SC
05
—
T49187
—
SC
Enumeration date
06/23/2006
Last updated
04/24/2026
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