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General NPI Number Information
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NPI Number | 1447439229
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Entity Type | Organization
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Legal Business Name | THOMAS L EDWARDS DO INC
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Dates
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Enumeration Date | 10/30/2007
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Last Update Date | 06/27/2016
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Provider Practice Location Address
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Address Line | 12844 JOE HARIG ROAD
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City | SAN ANTONIO
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State | FL
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Zip | 33576
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Country | US
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Telephone | 352-588-0476
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Fax | 888-523-3008
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Provider Business Mailing Address
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Address Line | 12844 JOE HARIG ROAD
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City | SAN ANTONIO
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State | FL
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Zip | 33576
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Country | US
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Telephone | 352-588-0476
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Fax | 888-523-3008
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. THOMAS LLOYD EDWARDS
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Credential | DO
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Telephone | 352-588-0476
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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