Provider Demographics
NPI:1669578639
Name:AUSTIN, MONTEITH DUMOND (MD)
Entity type:Individual
Prefix:DR
First Name:MONTEITH
Middle Name:DUMOND
Last Name:AUSTIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:811 EAST 11TH STREET
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2113
Mailing Address - Country:US
Mailing Address - Phone:559-391-3120
Mailing Address - Fax:559-391-3122
Practice Address - Street 1:811 EAST 11TH STREET
Practice Address - Street 2:
Practice Address - City:REEDLEY
Practice Address - State:CA
Practice Address - Zip Code:93654-2113
Practice Address - Country:US
Practice Address - Phone:559-391-3120
Practice Address - Fax:559-391-3122
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2016-08-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA98715208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A987150Medicare PIN