Provider Demographics
NPI:1790872174
Name:ROYAL, JAMES KEVIN (DR)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KEVIN
Last Name:ROYAL
Suffix:
Gender:M
Credentials:DR
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:121 N 20TH ST
Mailing Address - Street 2:#6
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-5449
Mailing Address - Country:US
Mailing Address - Phone:334-749-3385
Mailing Address - Fax:334-742-9243
Practice Address - Street 1:121 N 20TH ST
Practice Address - Street 2:#6
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5449
Practice Address - Country:US
Practice Address - Phone:334-749-3385
Practice Address - Fax:334-742-9243
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2010-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL21764207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000035483Medicaid
AL000035483Medicare PIN
ALG48503Medicare UPIN