Healthcare Provider Details

I. General information

NPI: 1548299365
Provider Name (Legal Business Name): MONTGOMERY PSYCHIATRY, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/23/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 LONGFIELD CT
MONTGOMERY AL
36117-8055
US

IV. Provider business mailing address

1040 LONGFIELD CT
MONTGOMERY AL
36117-8055
US

V. Phone/Fax

Practice location:
  • Phone: 334-288-9009
  • Fax: 334-288-9497
Mailing address:
  • Phone: 334-288-9009
  • Fax: 334-288-9497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM C. FREEEMAN
Title or Position: OWNER
Credential: M.D.
Phone: 334-288-9009