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General NPI Number Information
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NPI Number | 1467447425
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Entity Type | Individual
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Provider Name | DAVID N MONTGOMERY OD
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Gender | Male
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Dates
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Enumeration Date | 09/15/2005
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Last Update Date | 08/02/2024
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Provider Practice Location Address
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Address Line | 5491 CREEKWOOD PARK BLVD
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City | LENOIR CITY
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State | TN
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Zip | 37772-1204
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Country | US
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Telephone | 800-500-4667
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Fax | 833-448-2983
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Provider Business Mailing Address
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Address Line | 1275 DICK LONAS RD
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City | KNOXVILLE
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State | TN
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Zip | 37909-1382
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Country | US
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Telephone | 865-584-4747
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Fax | 865-381-1509
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODT0682
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License Number State | TN
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