Individual
DR. DAVID A MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
95 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9604
(270) 465-3812
(270) 465-8352
Mailing address
95 KINGSWOOD DR, CAMPBELLSVILLE, KY 42718-9604
(270) 465-3812
(270) 465-8352
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29718
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0989813
MEDICARE HOSPITAL
KY
01
—
29718
STATE LICENSE
KY
05
—
64297187
—
KY
Enumeration date
08/19/2005
Last updated
03/12/2009
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