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General NPI Number Information
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NPI Number | 1730412636
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Entity Type | Individual
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Provider Name | JEAN-PAUL MONTREUIL PA
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Gender | Male
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Dates
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Enumeration Date | 09/09/2009
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Last Update Date | 01/17/2024
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Provider Practice Location Address
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Address Line | 1101 GRADE LN BLDG 900
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City | LOUISVILLE
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State | KY
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Zip | 40213-2673
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Country | US
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Telephone | 502-299-9863
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Fax |
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Provider Business Mailing Address
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Address Line | 7149 BLACKSHEEP RUN RD TMC-5, AVIATION CLINIC
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City | FORT CAMPBELL
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State | KY
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Zip | 42223
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Country | US
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Telephone | 270-412-8688
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Fax | 270-412-8421
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA2329
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License Number State | KY
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