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General NPI Number Information
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NPI Number | 1871964379
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Entity Type | Individual
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Provider Name | SCOTT ROYER
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Gender | Male
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Dates
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Enumeration Date | 10/10/2015
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Last Update Date | 10/10/2015
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Provider Practice Location Address
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Address Line | 118 S COMMERCIAL ST
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City | WORTHINGTON
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State | IN
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Zip | 47471-1712
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Country | US
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Telephone | 812-821-7780
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Fax |
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Provider Business Mailing Address
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Address Line | 12324 S COUNTY ROAD 300 E
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City | COAL CITY
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State | IN
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Zip | 47427-8935
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Country | US
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Telephone | 812-875-8866
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Fax | 812-875-2045
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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 | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 24005869A
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License Number State | IN
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