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General NPI Number Information
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NPI Number | 1447243662
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Entity Type | Organization
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Legal Business Name | ST ROY FAMILY CARE INC
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Dates
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Enumeration Date | 08/23/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1002 12TH ST
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City | LAFAYETTE
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State | LA
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Zip | 70501-6224
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Country | US
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Telephone | 337-769-1095
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Fax | 337-769-1098
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Provider Business Mailing Address
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Address Line | PO BOX 91133
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City | LAFAYETTE
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State | LA
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Zip | 70509-1133
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Country | US
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Telephone | 337-769-1095
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Fax | 337-769-1098
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. JOHN FRANCIS STROY
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Credential | M.D.
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Telephone | 337-769-1095
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 13348R
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License Number State | LA
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