Provider Demographics
NPI:1861558041
Name:INTERNAL MEDICINE LAB.
Entity type:Organization
Organization Name:INTERNAL MEDICINE LAB.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LAB DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:ROYAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:334-749-3385
Mailing Address - Street 1:PO BOX 2527
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36803-2527
Mailing Address - Country:US
Mailing Address - Phone:334-749-3385
Mailing Address - Fax:334-745-7672
Practice Address - Street 1:121 N 20TH ST STE 6
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-5454
Practice Address - Country:US
Practice Address - Phone:334-749-3385
Practice Address - Fax:334-745-7672
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:INTERNAL MED ASSOCIATE P C
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-29
Last Update Date:2007-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory