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General NPI Number Information
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NPI Number | 1700350410
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Entity Type | Individual
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Provider Name | JEFFREY MICHAEL ROY PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/15/2019
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 1871 EVELYN BYRD AVE
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City | HARRISONBURG
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State | VA
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Zip | 22801-3487
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Country | US
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Telephone | 540-564-5800
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Fax | 833-552-3026
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Provider Business Mailing Address
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Address Line | PO BOX 1430
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City | HARRISONBURG
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State | VA
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Zip | 22803-1430
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Country | US
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Telephone | 540-564-5800
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Fax | 833-552-3026
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110006641
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License Number State | VA
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