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General NPI Number Information
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NPI Number | 1922042720
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Entity Type | Individual
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Provider Name | KENNETH DALE MONTGOMERY M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 01/14/2010
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Provider Practice Location Address
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Address Line | 160 E HANOVER AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960-3150
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Country | US
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Telephone | 973-538-2334
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Fax | 973-538-1297
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Provider Business Mailing Address
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Address Line | 160 E HANOVER AVE PO BOX 1446
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City | MORRISTOWN
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State | NJ
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Zip | 07960-3150
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Country | US
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Telephone | 973-538-2334
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Fax | 973-538-1297
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 188735-1
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License Number State | NY
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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 | 25MA08100000
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License Number State | NJ
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