Individual
DR. ROY R DANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
305 W JACKSON ST STE 206, CARBONDALE, IL 62901-1474
(618) 457-3006
(618) 457-3008
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036157894
IL
208600000X
Surgery Physician
Primary
117216
MO
208600000X
Surgery Physician
30773
KS
2086S0102X
Surgical Critical Care Physician
036157894
IL
2086S0127X
Trauma Surgery Physician
036157894
IL
2086S0127X
Trauma Surgery Physician
117216
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200262370J
—
KS
Enumeration date
02/23/2006
Last updated
09/14/2021
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