Provider Demographics
NPI:1821020207
Name:MONTGOMERY, LINDA C (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:MONTGOMERY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:CURCHIN
Other - Last Name:MONTGOMERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:303-493-7000
Mailing Address - Fax:
Practice Address - Street 1:3055 ROSLYN ST
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3323
Practice Address - Country:US
Practice Address - Phone:720-848-0000
Practice Address - Fax:720-848-9050
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2013-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME81617207Q00000X
CO44956207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL264186100Medicaid
CO46982388Medicaid
COC807359Medicare PIN
FL264186100Medicaid