Provider Demographics
NPI:1437570488
Name:MARGARET W ROYSON DO LLC
Entity Type:Organization
Organization Name:MARGARET W ROYSON DO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/ MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:W
Authorized Official - Last Name:ROYSON
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:505-823-1805
Mailing Address - Street 1:4163 MONTGOMERY BLVD NE STE 390
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-6742
Mailing Address - Country:US
Mailing Address - Phone:505-226-2300
Mailing Address - Fax:505-369-0727
Practice Address - Street 1:4163 MONTGOMERY BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-6742
Practice Address - Country:US
Practice Address - Phone:505-226-2300
Practice Address - Fax:505-369-0727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-18
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty