Provider Demographics
NPI:1588635114
Name:ANDREWS, ROY ROBERT (DO)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:ROBERT
Last Name:ANDREWS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 729
Mailing Address - Street 2:
Mailing Address - City:SALTVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24370-0729
Mailing Address - Country:US
Mailing Address - Phone:276-669-5179
Mailing Address - Fax:276-466-8870
Practice Address - Street 1:2195 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:VA
Practice Address - Zip Code:24201-3655
Practice Address - Country:US
Practice Address - Phone:276-669-5179
Practice Address - Fax:276-466-8870
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102201417207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA012888S75Medicare PIN
VA007926T25Medicare PIN
H60976Medicare UPIN