Healthcare Provider Details

I. General information

NPI: 1437570488
Provider Name (Legal Business Name): MARGARET W ROYSON DO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2013
Last Update Date: 11/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4163 MONTGOMERY BLVD NE
ALBUQUERQUE NM
87109-6742
US

IV. Provider business mailing address

4163 MONTGOMERY BLVD NE STE 390
ALBUQUERQUE NM
87109-6742
US

V. Phone/Fax

Practice location:
  • Phone: 505-226-2300
  • Fax: 505-369-0727
Mailing address:
  • Phone: 505-226-2300
  • Fax: 505-369-0727

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARGARET W ROYSON
Title or Position: CEO/ MEDICAL DIRECTOR
Credential: DO
Phone: 505-823-1805