# ROYAL OAK MEDICAL ASSOCIATES PC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ROYAL OAK MEDICAL ASSOCIATES PC
- **Other names:** BLUE RIDGE FAMILY MEDICINE
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1588910756
- **Legal business name:** ROYAL OAK MEDICAL ASSOCIATES PC
- **Authorized official:** KIMBERLY K LACY DO (PHYSICIAN)
- **Authorized official phone:** (276) 686-4007

## Contact information

- **Practice address:** 445 GIENOW RD, RURAL RETREAT, VA 24368-3210
- **Practice address phone:** (276) 686-4007
- **Practice address fax:** (276) 686-4581
- **Mailing address:** 445 GIENOW RD, RURAL RETREAT, VA 24368-3210
- **Mailing address phone:** (276) 686-4007
- **Mailing address fax:** (276) 686-4581

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/25/2012
- **Last updated:** 07/25/2012