Provider Demographics
NPI:1437263340
Name:DEEN, ROY WENDELL (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:WENDELL
Last Name:DEEN
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 1:800 W THOMAS ST
Mailing Address - Street 2:
Mailing Address - City:MILLEDGEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31061-2674
Mailing Address - Country:US
Mailing Address - Phone:478-453-9346
Mailing Address - Fax:478-453-0205
Practice Address - Street 1:800 W THOMAS ST
Practice Address - Street 2:
Practice Address - City:MILLEDGEVILLE
Practice Address - State:GA
Practice Address - Zip Code:31061-2674
Practice Address - Country:US
Practice Address - Phone:478-453-9346
Practice Address - Fax:478-453-0205
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2012-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA27799207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine