Provider Demographics
NPI:1912970450
Name:MONTGOMERY PHYSICAL MEDICINE & REHABILITATION, P.C.
Entity Type:Organization
Organization Name:MONTGOMERY PHYSICAL MEDICINE & REHABILITATION, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NARAYANA RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:PARASU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-280-9848
Mailing Address - Street 1:PO BOX 242009
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36124-2009
Mailing Address - Country:US
Mailing Address - Phone:334-280-9848
Mailing Address - Fax:334-280-9849
Practice Address - Street 1:4465 NARROW LANE RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2953
Practice Address - Country:US
Practice Address - Phone:334-280-9848
Practice Address - Fax:334-280-9849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00026755204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherTAX ID