Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0214X | Pediatric Pulmonologist | 58146 | TN |
NPI | 1265478481 |
---|---|
Provider Name | Dr. Frederick Henry Royce JR. |
First Address | Memphis, TN 38105-4607 |
Second Address | Memphis, TN 38105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2006 |
Last Update Date | 28/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004779 | (02) | |
2254591 | (05) | OH |