Male or Other

Jeremy T. Royal M.D.

Diagnostic Radiology Physician in Atlanta, GA(View on Map)

Full Name

Jeremy Todd Royal M.D.

NPI Number

1730382821

NPI Type

Individual Provider

Gender

Male

Enumeration Date

06/07/2007

Specialties

(Taxonomies)

Code

2085R0202X

Primary Taxonomy

Yes

Licenses

State

Alabama
Georgia
South Carolina

License Number

28589
67312
MD36307

Contact
Information

Purpose

Mailing
Location

Address

5605 GLENRIDGE DR STE 325
1000 JOHNSON FERRY RD

City

Atlanta
Atlanta

State

GA
GA

Postal Code

30342-1365
30342

Country

US
US

Telephone Number

(678) 553-7783
(404) 851-6323

Identifiers

Identifier

051116335
129081
051116340
051116342
051116344
129079
129080
129084
051116334
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Identifier State

AL
AL
AL
AL
AL
AL
AL
AL
AL
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Identifier Issuer

BCBS
Unknown
BCBS
BCBS
BCBS
Unknown
Unknown
Unknown
BCBS
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 05/06/2019

Provider Address

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