Organization
ROY A. DEFRIES, M.D., L.L.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROY A. DEFRIES MD (OWNER)
(812) 682-3138
Entity
Organization
Contact information
Practice address
3524 N 1ST AVE, EVANSVILLE, IN 47710-3320
(812) 425-1555
(812) 425-1815
Mailing address
3524 N 1ST AVE, EVANSVILLE, IN 47710-3320
(812) 425-1555
(812) 425-1815
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01031109
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100246950B
—
IN
Enumeration date
06/01/2007
Last updated
08/18/2014
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