Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 28832 | KY |
Y | 208600000X | Surgeon | 28832 | KY |
N | 2086X0206X | Surgical Oncologist | 28832 | KY |
N | 208G00000X | Cardiothoracic Vascular Surgeon | 28832 | KY |
NPI | 1326066648 |
---|---|
Provider Name | Richard C. Montgomery |
First Address | London, KY 40743-0936 |
Second Address | Bardstown, KY 40004-8040 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 10/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G41921 | (02) |