Healthcare Provider Details

I. General information

NPI: 1902082845
Provider Name (Legal Business Name): JAMES RAYMOND EDINGER JR. MSN- CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2008
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5969 SNOWLIGHT CT
SYLVANIA OH
43560-2567
US

IV. Provider business mailing address

5969 SNOWLIGHT CT
SYLVANIA OH
43560-2567
US

V. Phone/Fax

Practice location:
  • Phone: 419-705-9400
  • Fax:
Mailing address:
  • Phone: 419-705-9400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number371392
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number12435
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: