Individual
MR. ROYDELL HERRON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 SKYLINE DR, JACKSON, TN 38301-3923
(731) 541-5000
Mailing address
1150 BETTY MANLEY RD, DENMARK, TN 38391-1854
(731) 217-6586
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
211952
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
31490
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q073865
—
TN
Enumeration date
09/07/2021
Last updated
02/16/2026
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