MEDICARE: ABBE E MONTGOMERY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	MD425882	PA
2	207P00000X	Emergency Medicine Physician	MD27282	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467412056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBE E MONTGOMERY MD

Provider Business Mailing Address
First Line	:	PO BOX 48068
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32247-8068
Country	:	US
Telephone Number	:	866-898-7148
Fax Number	:	904-805-1301

Provider Business Practice Location Address
First Line	:	1046 6TH AVE SW
Second Line	:
City	:	ALBANY
State	:	OR
Zip	:	97321-1916
Country	:	US
Telephone Number	:	541-812-4000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/27/2006
Last Update Date	:	08/16/2023

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Directions to “ ABBE E MONTGOMERY MD” Practice Location

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