Provider Demographics
NPI:1386758613
Name:OVERTON, ROY WILLIAM III (DO)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:WILLIAM
Last Name:OVERTON
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5927 HIGHLAND CIR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2825
Mailing Address - Country:US
Mailing Address - Phone:515-208-1389
Mailing Address - Fax:
Practice Address - Street 1:5927 HIGHLAND CIR
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-2825
Practice Address - Country:US
Practice Address - Phone:515-327-2089
Practice Address - Fax:515-440-4599
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA02075207QG0300X
IADO-2075207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1386758613OtherBCBS
IA1386758613Medicaid
IAIB2629001Medicare PIN
IAB85131Medicare UPIN