Individual
MR. WILLIAM SHERMAN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
11203 MAIN ST, MARTIN, KY 41649-0910
(606) 285-6400
Mailing address
PO BOX 2081, PRESTONSBURG, KY 41653-2081
(606) 791-0179
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1039197 696
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
430018294
RAILROAD MEDICARE
KY
05
—
65927568
—
KY
05
—
7100037180
—
KY
Enumeration date
12/14/2006
Last updated
08/05/2015
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