<Unavail>

LBN: Michael Montgomery Od Pc
<Unavail> is an health care organization with primary practice located at 279 E Elm , Lebanon MO 65536. The organization recently has 3 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Allopathic & Osteopathic Physicians / Ophthalmology, Suppliers / Eyewear Supplier (Equipment, not the service). Allopathic & Osteopathic Physicians / Ophthalmology is the primary health care specialty. Michael Montgomery Od Pc can be contacted via phone (417) 532-2562, or through Montgomery, Michael R via phone (417) 532-2562.

Contact Information

Primary practice address
279 E Elm Lebanon MO 65536
Phone: (417) 532-2562
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Montgomery, Michael R O.D., P.C.
Phone: (417) 532-2562

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2552 Missouri
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X TO2552 Missouri
Suppliers / Eyewear Supplier (Equipment, not the service) 332H00000X 2552 Missouri

Profile Details

NPI number 1316078868
LBN Legal business name Michael Montgomery Od Pc
DBA Doing business as <Unavail>
Authorized official Montgomery, Michael R O.D., P.C.
Entity Organization
Organization subpart 1 No
Enumeration date Mar 8th, 2007
Last updated Mar 14th, 2011 - about 15 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316078868 NPPES
Missouri MEDICAID 312368301

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