Individual
DR. ROY WILLIS MINER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 TAYLOR RD, MONTGOMERY, AL 36117-3512
(334) 747-8448
Mailing address
PO BOX 3395, EVANSVILLE, IN 47732-3395
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
42129
AL
207Q00000X
Family Medicine Physician
01064362A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200877220
—
IN
01
—
50028039
KY PASSPORT
KY
01
—
621882
ANTHEM
IN
05
—
7100077120
—
KY
01
—
9189395
AETNA
IN
Enumeration date
06/05/2007
Last updated
11/24/2024
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