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General NPI Number Information
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NPI Number | 1447455977
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Entity Type | Individual
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Provider Name | KACEY A MONTGOMERY MD
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Gender | Female
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 10/12/2016
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Provider Practice Location Address
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Address Line | 4901 MARKET PLACE RD
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City | PENSACOLA
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State | FL
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Zip | 32504-8986
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Country | US
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Telephone | 850-484-4080
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 11637
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City | PENSACOLA
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State | FL
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Zip | 32524-1637
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Country | US
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Telephone | 850-484-4080
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Fax |
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | FE60217645
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | ME109250
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | ME109250
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License Number State | FL
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