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NPI Code Detail

MEDICARE: AARON A MONTGOMERY NP

MEDICARE: AARON A MONTGOMERY NP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerRN277626GA
2163WE0003XEmergency Registered NurseRN277626GA

General Provider Information

NPI Number : 1083247951
Entity Type Code : Individual
Provider Name (Legal Business Name) : AARON A MONTGOMERY NP
Provider Business Mailing Address
First Line : 1265 AUTUMN HILL LN
Second Line :
City : STONE MOUNTAIN
State : GA
Zip : 30083-5200
Country : US
Telephone Number : 860-459-5575
Fax Number :
Provider Business Practice Location Address
First Line : 3350 BRECKINRIDGE BLVD STE 200
Second Line :
City : DULUTH
State : GA
Zip : 30096-4959
Country : US
Telephone Number : 404-728-4164
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/19/2020
Last Update Date : 10/13/2025

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