Provider Demographics
NPI:1639296965
Name:ROYAL CLINIC PC
Entity Type:Organization
Organization Name:ROYAL CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FESTUS
Authorized Official - Middle Name:N
Authorized Official - Last Name:ARINZE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:731-784-2442
Mailing Address - Street 1:705 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:HUMBOLDT
Mailing Address - State:TN
Mailing Address - Zip Code:38343-3034
Mailing Address - Country:US
Mailing Address - Phone:731-784-2442
Mailing Address - Fax:731-784-1000
Practice Address - Street 1:705 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:HUMBOLDT
Practice Address - State:TN
Practice Address - Zip Code:38343-3034
Practice Address - Country:US
Practice Address - Phone:731-784-2442
Practice Address - Fax:731-784-1000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-23
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3331213Medicare ID - Type UnspecifiedGROUP NUMBER