A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] | |
Pain |
261QP3300X | |||
Sports Medicine |
2081S0010X | 25 | Physician/Physical Medicine and Rehabilitation | |
Sports Medicine |
2083S0010X | 84 | Physician/Preventive Medicine |
| NPI # | 1942845417 |
| LBN Legal business name | ROYAL BLUE MEDICAL CENTER GA. INC |
| Authorized official | OMAR ELLISON - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/08/2019 |
| Last updated | 09/08/2020 - About 6 years ago |
| Identifiers | n/a |
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