Healthcare Provider Details

I. General information

NPI: 1982706438
Provider Name (Legal Business Name): DEBRA LYNN ROYCE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 MINER ST
SARCOXIE MO
64862-9210
US

IV. Provider business mailing address

1407 MINER ST PO BOX 622
SARCOXIE MO
64862-9210
US

V. Phone/Fax

Practice location:
  • Phone: 417-548-3334
  • Fax:
Mailing address:
  • Phone: 417-548-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR9J86
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: