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Individual

DR. ALPHONSE KENISON ROY III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4824 CLEARY AVE, METAIRIE, LA 70002-1316
(504) 453-7598
Mailing address
4824 CLEARY AVE, METAIRIE, LA 70002-1316
(504) 453-7598

Taxonomy

Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
12078
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1324400
LA
Enumeration date
07/05/2005
Last updated
10/25/2024
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