MEDICARE: DR. MOYNE KORNMAN MONTS 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
1	207ZB0001X	Blood Banking & Transfusion Medicine Physician	J9898	TX
2	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	J9898	TX

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

General Provider Information

NPI Number	:	1689760365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOYNE KORNMAN MONTS M.D.

Provider Business Mailing Address
First Line	:	1106 N. 6TH STREET
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601
Country	:	US
Telephone Number	:	903-757-3223
Fax Number	:	844-315-0256

Provider Business Practice Location Address
First Line	:	1106 N. 6TH STREET
Second Line	:
City	:	LONGVIEW
State	:	TX
Zip	:	75601
Country	:	US
Telephone Number	:	903-757-3223
Fax Number	:	844-315-0256

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

Provider Enumeration Date	:	10/04/2006
Last Update Date	:	01/15/2025

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