National Provider Identifier Database

TOM MONTGOMERY III
Nursing Home Administrator

An individual, often licensed by the state, who is responsible for the management of a nursing home.


Contact Information

TOM MONTGOMERY III
1929 BETTY JANE LN
MUSKOGEE, OK74403-1581
Phone: 918-683-9407
Fax:
Website:
Specialty Taxonomy Code
* Nursing Home Administrator 376G00000X

* Indicates primary specialty

NPI Profile & details for TOM MONTGOMERY III

NPI Number 1205225117
Credentials
Entity Individual
Enumeration date 01/15/2015
Last updated 01/15/2015 - About 11 years ago
Sole proprietor1 No
Identifiers
  • OK License #: 2286
  • OK Medicaid: 200106120A
  • OK Other: 375174 MEDICARE PROVIDER ENROLLMENT
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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