Healthcare Provider Details

I. General information

NPI: 1467648097
Provider Name (Legal Business Name): ELLIOT P ROYSTON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2007
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2785 LAWRENCEVILLE HWY STE 210
DECATUR GA
30033-2515
US

IV. Provider business mailing address

2785 LAWRENCEVILLE HWY STE 210
DECATUR GA
30033-2515
US

V. Phone/Fax

Practice location:
  • Phone: 770-939-5130
  • Fax: 770-908-8619
Mailing address:
  • Phone: 770-939-5130
  • Fax: 770-908-8619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ELLIOT PAUL ROYSTON
Title or Position: PRESIDENT
Credential: MD
Phone: 770-939-5130