Individual
DR. MARK JOSEPH ROY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
640 SAINT CHARLES ST, THIBODAUX, LA 70301-3422
(985) 446-1717
(985) 446-9542
Mailing address
640 SAINT CHARLES ST, THIBODAUX, LA 70301-3422
(985) 446-1717
(985) 446-9542
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1354-488T
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1128015
—
LA
Enumeration date
03/16/2006
Last updated
07/21/2021
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