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Organization

MONTGOMERY TRAUMA ASSOCIATES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY G MILLER (BILLING MANAGER)
(334) 613-7076
Entity
Organization

Contact information

Practice address
2055 E SOUTH BLVD, SUITE 601, MONTGOMERY, AL 36116-2001
(334) 281-9000
(334) 281-8262
Mailing address
2055 E SOUTH BLVD, SUITE 601, MONTGOMERY, AL 36116-2001
(334) 281-9000
(334) 281-8262

Taxonomy

Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
26765
AL
305R00000X
Preferred Provider Organization
Primary
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1659454254
VERMILLION NPI
AL
01
51001703
BCBS AL VERMILLION
AL
05
529926030
AL
Enumeration date
12/05/2006
Last updated
05/02/2008
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