Provider Demographics
NPI:1932278652
Name:OB-GYN ASSOCIATES OF MONTGOMERY, P.C.
Entity Type:Organization
Organization Name:OB-GYN ASSOCIATES OF MONTGOMERY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEIGH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BROOKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:334-279-9333
Mailing Address - Street 1:495 TAYLOR RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-3513
Mailing Address - Country:US
Mailing Address - Phone:334-279-9333
Mailing Address - Fax:334-279-9057
Practice Address - Street 1:495 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3513
Practice Address - Country:US
Practice Address - Phone:334-279-9333
Practice Address - Fax:334-279-9057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2013-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No261QR0206XAmbulatory Health Care FacilitiesClinic/CenterRadiology, MammographyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL=========OtherFEDERAL TAX ID
ALI324Medicare PIN
ALE013Medicare PIN