Provider Demographics
NPI:1104110196
Name:STARKEY, MONTE MONTGOMERY (MD)
Entity type:Individual
Prefix:
First Name:MONTE
Middle Name:MONTGOMERY
Last Name:STARKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 COMMERCE DR N
Mailing Address - Street 2:SUITE 21
Mailing Address - City:PEACHTREE CITY
Mailing Address - State:GA
Mailing Address - Zip Code:30269-3538
Mailing Address - Country:US
Mailing Address - Phone:678-951-3983
Mailing Address - Fax:678-487-8306
Practice Address - Street 1:2011 COMMERCE DR N
Practice Address - Street 2:SUITE 21
Practice Address - City:PEACHTREE CITY
Practice Address - State:GA
Practice Address - Zip Code:30269-3538
Practice Address - Country:US
Practice Address - Phone:678-951-3983
Practice Address - Fax:678-487-8306
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2024-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA71750207Q00000X
GA71570208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202G700017Medicare UPIN