Montgomery, Samuel Jacob

Montgomery, Samuel Jacob is an individual health care provider with primary practice located at 22995 Us Highway 76 , Clinton SC 29325-7529. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Montgomery, Samuel Jacob can be contacted via phone (864) 654-6706.

Contact Information

Primary practice address
22995 Us Highway 76 Clinton SC 29325-7529
Phone: (864) 654-6706
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 20855 South Carolina

Profile Details

NPI number 1467488551
LBN Legal business name Montgomery, Samuel Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 23rd, 2006
Last updated Jun 14th, 2024 - about 2 years ago

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 1467488551 NPPES
South Carolina Other 180045119 RAILROAD MEDICARE
South Carolina MEDICAID T49187 RAILROAD MEDICARE

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