Individual
BENJAMIN TITUS MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
(575) 396-6611
Mailing address
1600 N MAIN AVE, LOVINGTON, NM 88260-2813
(907) 563-3103
(907) 561-1862
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
4301060876
MI
208800000X
Urology Physician
Primary
MD2021-0606
NM
Other
Enumeration date
07/30/2008
Last updated
06/30/2021
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