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General NPI Number Information
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NPI Number | 1093837619
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Entity Type | Organization
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Legal Business Name | ROY E DENTON MD PA
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 02/21/2018
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Provider Practice Location Address
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Address Line | 2210 ROBINSON AVE
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City | CONWAY
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State | AR
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Zip | 72034-4943
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Country | US
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Telephone | 501-932-3500
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Fax | 501-932-3520
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Provider Business Mailing Address
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Address Line | 1138 N GERMANTOWN PKWY # 101-377
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City | CORDOVA
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State | TN
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Zip | 38016-5872
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Country | US
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Telephone | 901-737-3071
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Fax | 901-328-1888
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Authorized Official
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Title or Position | BILLIING MANAGER
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Name | NEIDA BYRD
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Credential |
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Telephone | 901-737-3071
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | C7072
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License Number State | AR
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