Provider Demographics
NPI:1447889597
Name:MONTGOMERY, JAMES HAMILTON (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:HAMILTON
Last Name:MONTGOMERY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5427 HWY 49 SOUTH
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075
Mailing Address - Country:US
Mailing Address - Phone:704-454-7268
Mailing Address - Fax:
Practice Address - Street 1:5427 HWY 49 SOUTH
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075
Practice Address - Country:US
Practice Address - Phone:704-454-7268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-01
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program