Healthcare Provider Details

I. General information

NPI: 1639118144
Provider Name (Legal Business Name): ROY WHIT DEAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2003 WILSON AVE FLORIDA THERAPY SERVICES DR ROY DEAL
PANAMA CITY FL
32405-4532
US

IV. Provider business mailing address

2003 WILSON AVE FLORIDA THERAPY SERVICES DR ROY DEAL
PANAMA CITY FL
32405-4532
US

V. Phone/Fax

Practice location:
  • Phone: 850-784-0187
  • Fax: 850-784-0344
Mailing address:
  • Phone: 850-784-0187
  • Fax: 850-784-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberME84774
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: