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NPI Code Detail

MEDICARE: MR. BILLY RAY EDWARDS JR. M.ED.

MEDICARE:  MR. BILLY RAY EDWARDS JR. M.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselor

General Provider Information

NPI Number : 1154500460
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. BILLY RAY EDWARDS JR. M.ED.
Provider Business Mailing Address
First Line : PO BOX 720221
Second Line :
City : NORMAN
State : OK
Zip : 73070-4168
Country : US
Telephone Number : 405-819-7467
Fax Number :
Provider Business Practice Location Address
First Line : 5131 N CLASSEN BLVD
Second Line :
City : OKLAHOMA CITY
State : OK
Zip : 73118-5258
Country : US
Telephone Number : 405-767-1126
Fax Number : 405-767-6285
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2007
Last Update Date : 11/02/2007

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Directions to “ MR. BILLY RAY EDWARDS JR. M.ED.” Practice Location

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