National Provider Identifier Database

ROYAL BLUE MEDICAL CENTER GA INC
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

ROYAL BLUE MEDICAL CENTER GA. INC
555 OLD NORCROSS RD STE 100
LAWRENCEVILLE, GA30046-8703
Phone: 704-277-1750
Fax:
Website:
Specialty Taxonomy Code
* General Practice 208D00000X
Pain 261QP3300X
Sports Medicine 2081S0010X
Sports Medicine 2083S0010X

* Indicates primary specialty

NPI Profile & details for ROYAL BLUE MEDICAL CENTER GA. INC

NPI Number 1942845417
Legal business name
LBN
ROYAL BLUE MEDICAL CENTER GA. INC
Authorized official OMAR ELLISON - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 11/08/2019
Last updated 09/08/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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