Provider Demographics
NPI:1144282013
Name:ROYAL, FRANK SPENCER (MD)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:SPENCER
Last Name:ROYAL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1122 N 25TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23223-5254
Mailing Address - Country:US
Mailing Address - Phone:804-649-1277
Mailing Address - Fax:804-649-1026
Practice Address - Street 1:1122 N 25TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-5254
Practice Address - Country:US
Practice Address - Phone:804-649-1277
Practice Address - Fax:804-649-1026
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2007-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101020159207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA517654OtherAETNA HEALTH
VA541150480OtherOTHER COMMERCIAL CARRIERS
VA59309OtherSOUTHERN HEALTH
VA005621381Medicaid
VA065765OtherANTHEM
VA30161OtherCARENET
VA541150480OtherVIRGINIA PREMIER
VA5621381VKOtherVIRGINIA COORDINATED CARE
VA541150480OtherVIRGINIA PREMIER
VA5621381VKOtherVIRGINIA COORDINATED CARE