MEDICARE: MONTOYA DEMONT GUNN IDC

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	1710I1002X	Independent Duty Corpsman

General Provider Information

NPI Number	:	1851592067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONTOYA DEMONT GUNN IDC

Provider Business Mailing Address
First Line	:	3007 12TH AVE
Second Line	:
City	:	MERIDIAN
State	:	MS
Zip	:	39305-4820
Country	:	US
Telephone Number	:	910-389-6914
Fax Number	:

Provider Business Practice Location Address
First Line	:	1801 FULLER RD
Second Line	:	SUITE A-01
City	:	MERIDIAN
State	:	MS
Zip	:	39309-5106
Country	:	US
Telephone Number	:	601-679-3973
Fax Number	:

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

Provider Enumeration Date	:	05/29/2007
Last Update Date	:	11/10/2009

Similar Medicare Providers

1245210269 — DR. ANN LOUISE LAGRECO D.D.S.
Practice Location Address:

NAVAL BRANCH HEALTH CLINIC , 1801 FULLER RD STE A-01
MERIDIAN, MS
39309-5106

Practice Phone: 601-679-2383
Practice Fax:

1972583664 — DR. ROWLAND EUGENE MCCOY DDS
Practice Location Address:

1801 FULLER RD , BLDG 367
MERIDIAN, MS
39309-5106

Practice Phone: 601-679-2022
Practice Fax:

1669442786 — DR. JAMES EUGENE CLARK D.D.S.
Practice Location Address:

1801 FULLER RD , SUITE D-18
MERIDIAN, MS
39309-5106

Practice Phone: 601-679-2383
Practice Fax:

1790755684 — MR. ROBERT JAMES WISHMEYER PA-C
Practice Location Address:

1801 FULLER RD
MERIDIAN, MS
39309-5106

Practice Phone: 601-679-2633
Practice Fax: 601-679-3232

1265463095 — MILLI M FLOYD R.PH.
Practice Location Address:

1801 FULLER RD
MERIDIAN, MS
39309-5106

Practice Phone: 601-679-2243
Practice Fax:

1033294533 — MR. CHRISTOPHER ROBERT SHARPE PA-C
Practice Location Address:

1801 FULLER RD
MERIDIAN, MS
39309-5106

Practice Phone: 601-679-3967
Practice Fax: 601-679-2973

Directions to “ MONTOYA DEMONT GUNN IDC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.