Provider Demographics
NPI:1427359751
Name:MONTGOMERY, JOSHUA J (PA-C)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:J
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:380 SUMMIT AVE
Mailing Address - Street 2:MSO PHYSICIAN BILLING
Mailing Address - City:STEUBENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43952-2667
Mailing Address - Country:US
Mailing Address - Phone:740-283-7597
Mailing Address - Fax:740-283-7190
Practice Address - Street 1:401 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:STEUBENVILLE
Practice Address - State:OH
Practice Address - Zip Code:43952-2846
Practice Address - Country:US
Practice Address - Phone:740-282-5000
Practice Address - Fax:740-282-5233
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.003172RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0077114Medicaid
OH50.003172OtherLICENSE
OH0077114Medicaid