Physician Compare National (NPI:1659340990)

HEALTHCARE PROVIDER: MICHAEL H MONTGOMERY MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1659340990
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9032114632
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100521000549
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	MONTGOMERY
	Individual professional last name
Provider First Name	MICHAEL
	Individual professional first name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	LOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
	Individual professional's medical school
Graduation Year	1974
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	THE FAMILY CLINIC INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0143225748
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	6
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	3921 HWY I 49 S SERVICE RD
	Group Practice or individual's line 1 address
City	OPELOUSAS
	Group Practice or individual's city
State	LA
	Group Practice or individual's state
Zip Code	705700758
	Group Practice or individual's zip code (9 digits when available)
Phone Number	3379425706
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	190017
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	OPELOUSAS GENERAL HEALTH SYSTEM
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	191319
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	ACADIA ST LANDRY
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y