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NPI Code Detail

MEDICARE: DR. RICHARD A. MONTGOMERY M.D.

MEDICARE:  DR. RICHARD A. MONTGOMERY  M.D.
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
12084P0800XPsychiatry PhysicianM-9072ID

General Provider Information

NPI Number : 1275567638
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RICHARD A. MONTGOMERY M.D.
Provider Business Mailing Address
First Line : PO BOX 277976
Second Line :
City : ATLANTA
State : GA
Zip : 30384-7976
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1906 FAIRVIEW AVE STE 220
Second Line :
City : CALDWELL
State : ID
Zip : 83605-5432
Country : US
Telephone Number : 208-795-5072
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/10/2006
Last Update Date : 03/22/2023

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Directions to “ DR. RICHARD A. MONTGOMERY M.D.” Practice Location

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