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General NPI Number Information
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NPI Number | 1528323748
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Entity Type | Organization
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Legal Business Name | F. RENEE MONTGOMERY, MD, PA
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Dates
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Enumeration Date | 07/13/2012
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Last Update Date | 07/13/2012
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Provider Practice Location Address
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Address Line | 2402 WILDWOOD AVE SUITE 115
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City | SHERWOOD
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State | AR
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Zip | 72120-5084
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Country | US
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Telephone | 501-992-2905
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Fax |
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Provider Business Mailing Address
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Address Line | 2233 GOFF DR
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City | BATESVILLE
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State | AR
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Zip | 72501-7742
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Country | US
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Telephone | 501-992-2905
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | F. RENEE MONTGOMERY
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Credential | M.D.
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Telephone | 501-992-2905
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | C7952
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License Number State | AR
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