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General NPI Number Information
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NPI Number | 1639245707
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Entity Type | Organization
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Legal Business Name | MONTGOMERY FAMILY PRACTICE PC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 07/13/2011
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Provider Practice Location Address
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Address Line | 1758 PARK PL STE 402
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City | MONTGOMERY
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State | AL
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Zip | 36106-1135
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Country | US
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Telephone | 334-265-7255
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Fax | 334-265-9055
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Provider Business Mailing Address
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Address Line | 1758 PARK PL STE 402
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City | MONTGOMERY
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State | AL
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Zip | 36106-1135
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Country | US
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Telephone | 334-265-7255
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Fax | 334-265-9055
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID COFFEY
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Credential | DO
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Telephone | 334-265-7255
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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