Provider Demographics
NPI:1699895128
Name:MONTEITH, JEFFREY R (MD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:R
Last Name:MONTEITH
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 1:3515 MASSILLON RD
Mailing Address - Street 2:STE 300
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-6400
Mailing Address - Country:US
Mailing Address - Phone:330-899-9350
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:3593 S ARLINGTON RD
Practice Address - Street 2:SUITE A
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5271
Practice Address - Country:US
Practice Address - Phone:330-899-9070
Practice Address - Fax:330-634-1329
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-29
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-092555207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2946576Medicaid
4269251Medicare PIN