Montgomery, Lori Ellen

Montgomery, Lori Ellen is an individual health care provider with primary practice located at 500 S. University Ave Ste 200, Little Rock AR 72205. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Montgomery, Lori Ellen can be contacted via phone (501) 664-4117.

Contact Information

Primary practice address
500 S. University Ave Ste 200 Little Rock AR 72205
Fax: (501) 664-1137
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C-7722 Arkansas

Profile Details

NPI number 1659340438
LBN Legal business name Montgomery, Lori Ellen
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 15th, 2006
Last updated Oct 11th, 2011 - about 13 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 1659340438 NPPES
Arkansas MEDICAID 122460001

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