Organization · NPI-2

Montgomery Pediatrics Incorporated

Preferred Provider Organization · Cincinnati, OH

NPI number1194917062
StatusActive
Last updated in NPPESAug 15, 2007

Details

NPI
1194917062
Entity type
Organization (NPI-2)
Legal business name
Montgomery Pediatrics Incorporated
Organization subpart
No
Enumeration date
Aug 15, 2007
Last updated
Aug 15, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305R00000X Preferred Provider Organization35041085LOHYes

Practice location

10700 Montgomery Rd
Suite 100
Cincinnati, OH 45242-3255

Phone 513-984-5552 · Fax 513-984-5554

Mailing address

10700 Montgomery Rd
Suite 100
Cincinnati, OH 45242-3255

Phone 513-984-5552 · Fax 513-984-5554

Authorized official

Jenny Vaughn
Office Manager
5139845552

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