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General NPI Number Information
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NPI Number | 1023523610
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Entity Type | Organization
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Legal Business Name | FAMILY ENT SPECIALISTS, LLC
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Dates
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Enumeration Date | 12/05/2017
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Last Update Date | 12/30/2021
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Provider Practice Location Address
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Address Line | 706 N BURKHARDT RD
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City | EVANSVILLE
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State | IN
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Zip | 47715-2740
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Country | US
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Telephone | 812-465-2727
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Fax | 812-297-8954
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Provider Business Mailing Address
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Address Line | PO BOX 3276
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City | EVANSVILLE
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State | IN
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Zip | 47731-3276
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Country | US
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Telephone | 812-473-0181
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Fax | 812-473-5822
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Authorized Official
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Title or Position | PRESIDENT
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Name | ALLISON K ROYER
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Credential | MD
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Telephone | 812-465-2727
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01065502A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 01073983A
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License Number State | IN
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