MEDICARE: TRAVIS J MONTGOMERY DPM

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
1	213ES0131X	Foot Surgery Podiatrist	07001006	IN
2	213ES0000X	Sports Medicine Podiatrist	07001006	IN
3	213ES0103X	Foot & Ankle Surgery Podiatrist	07001006A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154323731
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRAVIS J MONTGOMERY DPM

Provider Business Mailing Address
First Line	:	17300 WESTFIELD BLVD STE 110
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074-1436
Country	:	US
Telephone Number	:	317-567-1228
Fax Number	:	463-273-1890

Provider Business Practice Location Address
First Line	:	17300 WESTFIELD BLVD STE 110
Second Line	:
City	:	WESTFIELD
State	:	IN
Zip	:	46074-1436
Country	:	US
Telephone Number	:	317-567-1228
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2005
Last Update Date	:	03/19/2026

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Directions to “ TRAVIS J MONTGOMERY DPM” Practice Location

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