Healthcare Provider Details

I. General information

NPI: 1083247951
Provider Name (Legal Business Name): AARON A MONTGOMERY NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/19/2020
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5555 PEACHTREE DUNWOODY RD STE 201
SANDY SPRINGS GA
30342-1711
US

IV. Provider business mailing address

5555 PEACHTREE DUNWOODY RD STE 201
SANDY SPRINGS GA
30342-1711
US

V. Phone/Fax

Practice location:
  • Phone: 860-459-5575
  • Fax:
Mailing address:
  • Phone: 860-459-5575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN277626
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: