Montgomery, C. Ted
Montgomery, C. Ted is an individual health care provider with primary practice located at 3550 University Blvd S Ste 301, Jacksonville FL 32216-4225. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Montgomery, C. Ted can be contacted via phone (904) 384-2240.Contact Information
Primary practice address
3550 University Blvd S Ste 301
Jacksonville FL 32216-4225
Phone: (904) 384-2240
Fax: (904) 448-0030
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | ME10755 | Florida |
Profile Details
| NPI number | 1093717159 |
|---|---|
| LBN Legal business name | Montgomery, C. Ted |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 2nd, 2005 |
| Last updated | Nov 24th, 2009 - about 16 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093717159 | NPPES |
| Florida | MEDICAID | 371200100 |
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