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General NPI Number Information
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NPI Number | 1194762625
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Entity Type | Individual
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Provider Name | CHRISTOPHER ALTON EDENS MD
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Gender | Male
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Dates
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Enumeration Date | 06/01/2006
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Last Update Date | 05/07/2024
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Provider Practice Location Address
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Address Line | 2011 COMMERCE DR N STE 25
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-3538
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Country | US
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Telephone | 478-542-0311
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Fax |
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Provider Business Mailing Address
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Address Line | 2011 COMMERCE DR N STE 25
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City | PEACHTREE CITY
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State | GA
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Zip | 30269-3538
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Country | US
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Telephone | 844-994-6633
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Fax | 470-235-1861
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 42042
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 042042
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License Number State | GA
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