Healthcare Provider Details

I. General information

NPI: 1962678037
Provider Name (Legal Business Name): LEIGH BAILEY EDWARDS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2008
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 RIVER OAKS DRIVE SUITE 310
JACKSON MS
39232
US

IV. Provider business mailing address

1020 RIVER OAKS DR SUITE 310
JACKSON MS
39232-9500
US

V. Phone/Fax

Practice location:
  • Phone: 601-932-5006
  • Fax: 601-932-4548
Mailing address:
  • Phone: 601-932-5006
  • Fax: 601-932-4548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberT-1982
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: