| Dr Ty Montgomery, MD | |
|
2451 Intelliplex Dr, Shelbyville, IN 46176-8580 | |
| (317) 392-3211 | |
| Not Available |
| Full Name | Dr Ty Montgomery |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 2451 Intelliplex Dr, Shelbyville, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003947276 | NPI | - | NPPES |
| 000000204615 | Other | IN | ANTHEM BCBS |
| 200286380 | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 01047114A (Indiana) | Primary |
| Entity Name | X-ray Physicians Of Shelbyville Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1144351347 PECOS PAC ID: 2264420215 Enrollment ID: O20040506000325 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ty Montgomery, MD Po Box 58, Lima, OH 45802-0058 Ph: (866) 942-0799 | Dr Ty Montgomery, MD 2451 Intelliplex Dr, Shelbyville, IN 46176-8580 Ph: (317) 392-3211 |
Dr. Scott R Miller, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2451 Intelliplex Dr, Shelbyville, IN 46176 Phone: 317-392-3211 | |
Kenneth G Scott, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2451 Intelliplex Dr, Shelbyville, IN 46176 Phone: 317-392-3211 | |
Dr. Jonathan Bielefeld, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2451 Intelliplex Dr, Shelbyville, IN 46176 Phone: 317-392-3211 |