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General NPI Number Information
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NPI Number | 1043222508
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Entity Type | Individual
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Provider Name | PETER J MONTEYNE M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/13/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 2304 S. BURNSIDE AVE STE 2
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City | GONZALES
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State | LA
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Zip | 70737
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Country | US
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Telephone | 225-647-6533
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Fax | 225-644-7533
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Provider Business Mailing Address
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Address Line | P.O. BOX 1499
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City | GONZALES
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State | LA
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Zip | 70707-1499
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Country | US
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Telephone | 225-647-6533
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Fax | 225-644-7533
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 08055R
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License Number State | LA
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