Individual
STEPHEN MONTGOMERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
345 HIGHWAY 15 N, PONTOTOC, MS 38863-1105
(662) 489-7430
(662) 489-7938
Mailing address
345 HIGHWAY 15 N, PONTOTOC, MS 38863-1105
(662) 489-7430
(662) 489-7938
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10719
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00114314
—
MS
Enumeration date
03/27/2006
Last updated
02/21/2011
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