Healthcare Provider Details

I. General information

NPI: 1366021586
Provider Name (Legal Business Name): TIMOTHY SCOTT MONTET MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 06/12/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY
JEFFERSON LA
70121-2483
US

IV. Provider business mailing address

612 W CLAUDE ST
LAKE CHARLES LA
70605-3410
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-4190
  • Fax:
Mailing address:
  • Phone: 337-513-2301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number352419
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: