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General NPI Number Information
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NPI Number | 1104175512
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Entity Type | Organization
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Legal Business Name | ROY BRIAN ROBERTS, M.D., P.C.
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Dates
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Enumeration Date | 08/30/2012
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Last Update Date | 08/30/2012
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Provider Practice Location Address
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Address Line | 250 CHATEAU DR SW SUITE 220
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6436
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Country | US
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Telephone | 256-881-1989
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Fax | 256-319-1368
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Provider Business Mailing Address
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Address Line | 250 CHATEAU DR SW SUITE 220
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City | HUNTSVILLE
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State | AL
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Zip | 35801-6436
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Country | US
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Telephone | 256-881-1989
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Fax | 256-319-1368
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Authorized Official
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Title or Position | PYHSICIAN/ PRESIDENT
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Name | ROY BRIAN ROBERTS
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Credential | M.D.
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Telephone | 256-881-1989
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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 | 15274
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License Number State | AL
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