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General NPI Number Information
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NPI Number | 1548229636
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Entity Type | Individual
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Provider Name | GEORGE DANIEL EDWARDS III MD
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Gender | Male
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Dates
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Enumeration Date | 03/20/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 211 4TH STREET
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City | ALEXANDRIA
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State | LA
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Zip | 71301
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Country | US
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Telephone | 318-473-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 5150 HUNTER GROVE LANE
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City | ALEXANDRIA
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State | LA
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Zip | 71303
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Country | US
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Telephone | 318-487-0037
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 014574
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License Number State | LA
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