Individual
DR. ELLEN LEWIS ROYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2901 CORPORATE PARK DR, OPELIKA, AL 36801-7283
(334) 203-1766
(334) 203-1784
Mailing address
2901 CORPORATE PARK DR, OPELIKA, AL 36801-7283
(334) 203-1766
(334) 203-1784
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
21763
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000044755
—
AL
01
—
44755
BLUE CROSS & BLUE SHIELD
AL
Enumeration date
05/04/2006
Last updated
10/24/2017
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