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NPI Code Detail

MEDICARE: DR. BENJAMIN PATRICK ROY M.D.

MEDICARE: DR. BENJAMIN PATRICK ROY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician43562MN

General Provider Information

NPI Number : 1023076064
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BENJAMIN PATRICK ROY M.D.
Provider Business Mailing Address
First Line : 1233 34TH ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5112
Country : US
Telephone Number : 218-333-5000
Fax Number : 218-333-5360
Provider Business Practice Location Address
First Line : 1233 34TH ST NW
Second Line :
City : BEMIDJI
State : MN
Zip : 56601-5112
Country : US
Telephone Number : 218-333-5000
Fax Number : 218-333-5360
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/01/2006
Last Update Date : 05/03/2012

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Directions to “ DR. BENJAMIN PATRICK ROY M.D.” Practice Location

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