Healthcare Provider Details

I. General information

NPI: 1740261502
Provider Name (Legal Business Name): GEORGE A EDWARDS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 11/07/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4911 S ARROWHEAD DR #300
INDEPENDENCE MO
64055
US

IV. Provider business mailing address

10301 HICKMAN MILLS DR #100
KANSAS CITY MS
64131
US

V. Phone/Fax

Practice location:
  • Phone: 816-767-3263
  • Fax:
Mailing address:
  • Phone: 816-767-3263
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License NumberMDR9D67
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number04-19992
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: