Roy, David Bernard

Roy, David Bernard is an individual health care provider with primary practice located at 201 S Main St , Petal MS 39465-2362. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery. Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery is his primary health care specialty. Roy, David Bernard can be contacted via phone (601) 336-5626.

Contact Information

Primary practice address
201 S Main St Petal MS 39465-2362
Phone: (601) 336-5626
Fax: (601) 336-7826
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 4312 Arizona
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 4312 Arizona
Allopathic & Osteopathic Physicians / MOHS-Micrographic Surgery 207ND0101X 21178 Mississippi

Profile Details

NPI number 1801097019
LBN Legal business name Roy, David Bernard
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2007
Last updated Apr 15th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801097019 NPPES
Mississippi MEDICAID 09652756

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