Stephen Q Montgomery (NPI# 1699735159, PAC ID# 4486719978) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
Nation Provider ID (NPI) | 1699735159 |
PAC ID by PECOS | 4486719978 |
Professional Enrollment ID | I20090217000419 |
Full Name | Stephen Q Montgomery |
Organization Legal Name | PONTOTOC HEALTH SERVICES, INC. |
Address |
202 Main St Ecru MS 38841-9604 |
Phone Number | 6624894345 |
Gender | M |
Medical School | UNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE |
Graduation Year | 1984 |
Primary Specialty | FAMILY MEDICINE |
Group Practice PAC ID | 6002895356 |
Number of Group Practice Members | 17 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
251308 | PONTOTOC HEALTH SERVICE INC CAH |
250004 | NORTH MISSISSIPPI MEDICAL CENTER |
250006 | BAPTIST MEMORIAL HOSPITAL UNION COUNTY |
Address | Phone | Organization |
---|---|---|
202 Main St, Ecru, MS 38841-9604 | 6624894345 | PONTOTOC HEALTH SERVICES, INC. |
345 Hwy 15 N, Pontotoc Medical, Pontotoc, MS 38863-3311 | 6624897430 | PONTOTOC HEALTH SERVICES, INC. |
Organization Legal Name | PONTOTOC HEALTH SERVICES, INC. |
Physicians | 16 |
Name | Specialty | Organization | Address |
---|---|---|---|
Angela Christine Middleton | Nurse Practitioner | Pontotoc Health Services, Inc. | 176 S Main St, Pontotoc, MS 38863-3311 |
Jessica A Lauderdale | Family Medicine | Pontotoc Health Services, Inc. | 345 Hwy 15 N, Pontotoc Medical, Pontotoc, MS 38863-3311 |
Timothy Watson | Nurse Practitioner | Pontotoc Health Services, Inc. | 202 Main St, Ecru, MS 38841-9604 |
Kara N Rushing | Nurse Practitioner | Pontotoc Health Services, Inc. | 400 Doctors Dr, New Albany, MS 38652-3109 |
Amin A Bandealy | Emergency Medicine | Pontotoc Health Services, Inc. | 176 S Main St, Pontotoc, MS 38863-3311 |
Bradley J Bowlin | Family Medicine | Pontotoc Health Services, Inc. | 176 S Main St, Pontotoc, MS 38863-3311 |
Jennifer D Lowery | Family Medicine | Pontotoc Health Services, Inc. | 176 S Main St, Pontotoc, MS 38863-3311 |
Corey N Brown | Osteopathic Manipulative Medicine | Pontotoc Health Services, Inc. | 176 S Main St, Pontotoc, MS 38863-3311 |
Eydie Pullman | Clinical Social Worker | Pontotoc Health Services, Inc. | 400 Doctors Dr, New Albany, MS 38652-3109 |
Kiley P Shafer | Emergency Medicine | Pontotoc Health Services, Inc. | 176 S Main St, Pontotoc, MS 38863-3311 |
Street Address |
202 MAIN ST |
City | ECRU |
State | MS |
Zip | 38841-9604 |
Name | Specialty | Organization | Address |
---|---|---|---|
Timothy Watson | Nurse Practitioner | Pontotoc Health Services, Inc. | 202 Main St, Ecru, MS 38841-9604 |
Randall Craig Morthland | Chiropractic | 202 Main St, Savanna, IL 61074-1628 | |
Kyle John Pankonin | Chiropractic | 202 Main St, Lamberton, MN 56152-0517 |
Name | Specialty | Organization | Address |
---|---|---|---|
James W Speck | General Practice | Friendship Medical Clinic LLC | 5482 Hwy 15 N, Ecru, MS 38841-8471 |
Allison M Bailey | Nurse Practitioner | Friendship Medical Clinic LLC | 5482 Hwy 15 N, Ecru, MS 38841-8471 |
City | ECRU |
Zip Code | 38841 |
Specialty | FAMILY MEDICINE |
City + Specialty | ECRU + FAMILY MEDICINE |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.