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General NPI Number Information
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NPI Number | 1043284458
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Entity Type | Individual
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Provider Name | JONATHAN EDWARDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/14/2006
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Last Update Date | 07/30/2020
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Provider Practice Location Address
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Address Line | 2685 METROPOLITAN PKWY SW STE G
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City | ATLANTA
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State | GA
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Zip | 30315-7926
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Country | US
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Telephone | 404-596-4344
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Fax | 844-935-6886
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Provider Business Mailing Address
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Address Line | 147 ASHELAND AVE
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City | ASHEVILLE
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State | NC
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Zip | 28801-4013
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Country | US
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Telephone | 828-258-1188
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 94-00481
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 84130
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License Number State | GA
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