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General NPI Number Information
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NPI Number | 1871128264
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Entity Type | Individual
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Provider Name | ERIC MONTGOMERY
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Gender | Male
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Dates
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Enumeration Date | 03/06/2020
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 35TH MEDICAL GROUP UNIT 5024
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City | APO
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State | AP
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Zip | 96319-5024
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Country | US
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Telephone | 315-226-6750
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 76 BOX 7242
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City | APO
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State | AP
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Zip | 96319-0073
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Country | US
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Telephone |
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Fax |
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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 | 171000000X
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Taxonomy Name | Military Health Care Provider
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | DR.0067842
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License Number State | CO
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