Healthcare Provider Details

I. General information

NPI: 1366659823
Provider Name (Legal Business Name): EDWARD LYNN ATKINS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 03/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

62 PLANTATION DR APT. 154
HILTON HEAD ISLAND SC
29928-4159
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5600
  • Fax:
Mailing address:
  • Phone: 843-671-6774
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2077
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: