Healthcare Provider Details

I. General information

NPI: 1437195484
Provider Name (Legal Business Name): CHRISTOPHER P MONTVILLE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 08/11/2021
Certification Date: 08/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9160 CAROTHERS PARKWAY, STE 201 & 202
FRANKLIN TN
37067
US

IV. Provider business mailing address

9160 CAROTHERS PARKWAY, STE 201
FRANKLIN TN
37067
US

V. Phone/Fax

Practice location:
  • Phone: 615-721-6250
  • Fax: 513-585-0808
Mailing address:
  • Phone: 615-721-6250
  • Fax: 513-245-3110

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number35-088163
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: