Healthcare Provider Details

I. General information

NPI: 1467462382
Provider Name (Legal Business Name): STEPHEN KIRK EDWARDS DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2006
Last Update Date: 02/26/2023
Certification Date: 02/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6504 OLD SPRINGVILLE RD
PINSON AL
35126-3183
US

IV. Provider business mailing address

PO BOX 283
CLAY AL
35048
US

V. Phone/Fax

Practice location:
  • Phone: 205-520-0091
  • Fax:
Mailing address:
  • Phone: 205-520-0091
  • Fax: 205-520-0508

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1953
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: