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General NPI Number Information
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NPI Number | 1760520159
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Entity Type | Individual
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Provider Name | JAMES W MONTAG JR. P.A.-C
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Gender | Male
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 05/02/2013
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Provider Practice Location Address
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Address Line | 415 BOONES CREEK RD SUITE 1
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City | JONESBOROUGH
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State | TN
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Zip | 37659-5165
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Country | US
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Telephone | 423-788-3080
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Fax | 423-913-2810
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Provider Business Mailing Address
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Address Line | 415 BOONES CREEK RD SUITE 1
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City | JONESBOROUGH
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State | TN
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Zip | 37659-5165
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Country | US
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Telephone | 423-788-3080
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Fax | 423-913-2810
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA787
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License Number State | TN
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