Mcdonnell, Roy Dale

Mcdonnell, Roy Dale is an sole proprietor health care provider with primary practice located at 4117 Montgomery Blvd Ne , Albuquerque NM 87109-1102. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Mcdonnell, Roy Dale can be contacted via phone (505) 884-2927.

Contact Information

Primary practice address
4117 Montgomery Blvd Ne Albuquerque NM 87109-1102
Fax: (505) 884-2672
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1063513992
LBN Legal business name Mcdonnell, Roy Dale
Credentials B.C.O.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 25th, 2006
Last updated Jul 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1063513992 NPPES
New Mexico MEDICAID T2326

Popular Providers