Provider Demographics
NPI:1720035959
Name:ROYAL OAK MEDICAL ASSOCIATES PC
Entity Type:Organization
Organization Name:ROYAL OAK MEDICAL ASSOCIATES PC
Other - Org Name:SMYTH COUNTY FAMILY PHYSICIANS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:MCDOWELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:276-783-8123
Mailing Address - Street 1:1046 TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:VA
Mailing Address - Zip Code:24354-4138
Mailing Address - Country:US
Mailing Address - Phone:276-783-8123
Mailing Address - Fax:276-783-2879
Practice Address - Street 1:1046 TERRACE DR
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-4138
Practice Address - Country:US
Practice Address - Phone:276-783-8123
Practice Address - Fax:276-783-2879
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ROYAL OAK MEDICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-31
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA240901OtherANTHEM GROUP
VACD6056OtherRR MEDICARE
VACD6056OtherRR MEDICARE