Provider Demographics
NPI:1821064502
Name:MONTGOMERY, JAMES P (DPM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:P
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:406 S MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-3221
Mailing Address - Country:US
Mailing Address - Phone:724-837-5370
Mailing Address - Fax:724-837-7516
Practice Address - Street 1:406 S MAPLE AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-3221
Practice Address - Country:US
Practice Address - Phone:724-837-5370
Practice Address - Fax:724-837-7516
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2013-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC002626L213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0010457690006Medicaid
PA1296001OtherCIGNA
PA2736397OtherAETNA
PA102926OtherUPMC
PA1037399OtherGATEWAY
PA435230OtherBLUE SHIELD
PA245503OtherHEALTH AMERICA
PA480033657OtherRAILROAD
PA435230QH5Medicare PIN
PA435230OtherBLUE SHIELD