| Roy A. Defries, M.d., L.l.c. | |
|
3524 N 1st Ave Evansville IN 47710-3320 | |
| (812) 425-1555 | |
| (812) 425-1815 |
| Full Name | Roy A. Defries, M.d., L.l.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 3524 N 1st Ave, Evansville, Indiana |
| Authorized Official Name and Position | Roy A. Defries (OWNER) |
| Authorized Official Contact | 8126823138 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roy A. Defries, M.d., L.l.c. 3524 N 1st Ave Evansville IN 47710-3320 Ph: (812) 425-1555 | Roy A. Defries, M.d., L.l.c. 3524 N 1st Ave Evansville IN 47710-3320 Ph: (812) 425-1555 |
| NPI Number | 1831391804 |
|---|---|
| Provider Enumeration Date | 06/01/2007 |
| Last Update Date | 08/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831391804 | NPI | - | NPPES |
| 100246950B | Medicaid | IN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 01031109 (Indiana) | Primary |
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