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General NPI Number Information
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NPI Number | 1962269910
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Entity Type | Organization
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Legal Business Name | MONTGOMERY PEDIATRICS
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Dates
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Enumeration Date | 03/05/2024
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Last Update Date | 03/05/2024
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Provider Practice Location Address
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Address Line | 315 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-4915
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Country | US
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Telephone | 316-685-5326
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Fax | 316-685-3017
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Provider Business Mailing Address
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Address Line | 315 N HILLSIDE ST
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City | WICHITA
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State | KS
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Zip | 67214-4915
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Country | US
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Telephone | 316-685-5326
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Fax | 316-685-3017
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Authorized Official
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Title or Position | PHYSICIAN/OWNER
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Name | PHILIP MONTGOMERY
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Credential | MD
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Telephone | 785-214-2296
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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