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Mr. Tom Montgomery III
Nursing Home Administrator in Muskogee, Oklahoma
NPI 1205225117

Tom Montgomery III is a Nursing Home Administrator based in Muskogee, OK. Tom Montgomery III practices in Muskogee, OK. The NPI Number for Tom Montgomery III is 1205225117 and holds a License No. 2286 (Oklahoma).

The current practice location address for Tom Montgomery III is 1929 Betty Jane Ln, Muskogee, OK and can be reached out via phone at 918-683-9407.

Location: 1929 Betty Jane Ln, Muskogee, OK, 74403-1581
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1205225117
Provider Name
Tom Montgomery III
Credential
Provider Entity Type
Individual
Gender
Male
Address
1929 Betty Jane Ln, Muskogee, OK, 74403-1581
Phone Number
918-683-9407
Fax Number
Provider Enumeration Date
01/15/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
200106120A 05 OK
375174 01 OK MEDICARE PROVIDER ENROLLMENT
institution
Provider Business Practice Location Address Details
Address
1929 Betty Jane Ln
City
Muskogee
State
Oklahoma
Zip
74403-1581
Phone Number
918-683-9407
Fax Number
person
Provider Business Mailing Address Details
Address
1929 Betty Jane Ln
City
Muskogee
State
Oklahoma
Zip
74403-1581
Phone Number
918-683-9407
Fax Number
person
Provider's Taxonomy Details 1
Type
Nursing Service Related Providers
Classification
Nursing Home Administrator
Speciality
-
Taxonomy
376G00000X
License No.
2286 (Oklahoma)
Definition
An individual, often licensed by the state, who is responsible for the management of a nursing home.
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