Individual
DR. CHESTER THEO ROYALS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 DOCTORS DR STE C, DOUGLAS, GA 31533-2211
(912) 384-5832
(912) 383-8279
Mailing address
1100 WARD STREET EXT W, DOUGLAS, GA 31533-1902
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003150454A
—
GA
01
—
072653
MEDICAL LICENSE
GA
Enumeration date
09/18/2008
Last updated
03/17/2018
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