| Royal Surgery Center | |
|
107 Front St Ste 2126 Vidalia LA 71373-2835 | |
| (318) 336-2216 | |
| Not Available |
| Full Name | Royal Surgery Center |
|---|---|
| Speciality | Surgery |
| Location | 107 Front St Ste 2126, Vidalia, Louisiana |
| Authorized Official Name and Position | Royal Surgery Center (CEO) |
| Authorized Official Contact | 3188047480 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Royal Surgery Center 107 Front St Ste 2126 Vidalia LA 71373-2835 Ph: (318) 336-2216 | Royal Surgery Center 107 Front St Ste 2126 Vidalia LA 71373-2835 Ph: (318) 336-2216 |
| NPI Number | 1851113567 |
|---|---|
| Provider Enumeration Date | 10/25/2024 |
| Last Update Date | 05/12/2025 |
| Medicare PECOS PAC ID | 5991230674 |
|---|---|
| Medicare Enrollment ID | O20241203002601 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851113567 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 208600000X | Surgery | (* (Not Available)) | Primary |
| Provider Name | Javeed Khan |
|---|---|
| Provider Type | Practitioner - General Surgery |
| Provider Identifiers | NPI Number: 1780823906 PECOS PAC ID: 2860658010 Enrollment ID: I20220324001147 |
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