Provider Demographics
NPI:1952882524
Name:ERIN ROYAL, M.D. LLC
Entity Type:Organization
Organization Name:ERIN ROYAL, M.D. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:907-279-4953
Mailing Address - Street 1:2841 DEBARR RD STE 24
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99508-2945
Mailing Address - Country:US
Mailing Address - Phone:907-279-4953
Mailing Address - Fax:907-334-9667
Practice Address - Street 1:2841 DEBARR RD STE 24
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-2945
Practice Address - Country:US
Practice Address - Phone:907-279-4953
Practice Address - Fax:907-334-9667
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7795207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty