Provider Demographics
NPI:1407060999
Name:HERDMAN ROYAL, ANNE V (MD)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:V
Last Name:HERDMAN ROYAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:2738 E 51ST ST
Mailing Address - Street 2:SUITE 290
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74105
Mailing Address - Country:US
Mailing Address - Phone:918-712-5571
Mailing Address - Fax:918-747-7831
Practice Address - Street 1:6161 S YALE AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-1902
Practice Address - Country:US
Practice Address - Phone:918-712-5571
Practice Address - Fax:918-747-7831
Is Sole Proprietor?:No
Enumeration Date:2007-05-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA054747207ZP0102X
FL99674207ZP0102X
TN44327207ZP0102X
SC30758207ZP0102X
NC2008-714207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology