Healthcare Provider Details

I. General information

NPI: 1114737426
Provider Name (Legal Business Name): EMMA MICHELLE ROY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2025
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 S IRONWOOD DR STE 101
APACHE JUNCTION AZ
85120-5047
US

IV. Provider business mailing address

750 S IRONWOOD DR STE 101
APACHE JUNCTION AZ
85120-5047
US

V. Phone/Fax

Practice location:
  • Phone: 480-982-1265
  • Fax:
Mailing address:
  • Phone: 480-292-3230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number11607
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: