Montgomery, Jeremiah R

Montgomery, Jeremiah R is an individual health care provider with primary practice located at 2604 Medical Office Pl , Goldsboro NC 27534-9417. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Montgomery, Jeremiah R can be contacted via phone (919) 580-0004.

Contact Information

Primary practice address
2604 Medical Office Pl Goldsboro NC 27534-9417
Phone: (919) 580-0004
Fax: (919) 580-9099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 103911 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 103911 North Carolina

Profile Details

NPI number 1952390353
LBN Legal business name Montgomery, Jeremiah R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 18th, 2005
Last updated Jun 5th, 2024 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952390353 NPPES
Other Q01227 UPIN
Other 103911 UPIN

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