Individual
DR. ROY LAMAR TALLEY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 SIGMAN RD NE, SUITE 100, CONYERS, GA 30012
(770) 760-9360
(770) 760-9303
Mailing address
1301 SIGMAN RD NE, STE 100, CONYERS, GA 30012-3812
(770) 760-9360
(770) 760-9303
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
29957
GA
208VP0014X
Interventional Pain Medicine Physician
Primary
29957
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000357486F
—
GA
Enumeration date
10/03/2005
Last updated
10/19/2018
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