Provider Demographics
NPI:1841222759
Name:ROBERTS, ROY FRANKLIN JR (MD)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:FRANKLIN
Last Name:ROBERTS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1932 ALCOA HWY
Mailing Address - Street 2:BLDG. C STE. 270
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37920-1527
Mailing Address - Country:US
Mailing Address - Phone:865-251-4658
Mailing Address - Fax:865-251-4659
Practice Address - Street 1:1932 ALCOA HWY
Practice Address - Street 2:BLDG. C STE. 270
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37920-1527
Practice Address - Country:US
Practice Address - Phone:865-251-4658
Practice Address - Fax:865-251-4659
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12306208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051014141OtherBLUE CROSS BLUE SHIELD
AL529910640Medicaid
AL51505249OtherBLUE CROSS BLUE SHIELD
ALC78779Medicare UPIN
AL529910640Medicaid