Provider Demographics
NPI:1609055425
Name:MONTGOMERY FAMILY MEDICINE P.C.
Entity Type:Organization
Organization Name:MONTGOMERY FAMILY MEDICINE P.C.
Other - Org Name:MONTGOMERY SLEEP SLOUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFF
Authorized Official - Middle Name:
Authorized Official - Last Name:SENFT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-396-9100
Mailing Address - Street 1:8190 SEATON PL
Mailing Address - Street 2:SLEEP SUITE
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36116-7204
Mailing Address - Country:US
Mailing Address - Phone:334-396-9100
Mailing Address - Fax:334-396-9110
Practice Address - Street 1:8190 SEATON PL
Practice Address - Street 2:SLEEP SUITE
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-7204
Practice Address - Country:US
Practice Address - Phone:334-396-9100
Practice Address - Fax:334-396-9110
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MONTGOMERY FAMILY MEDICINE P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory