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General NPI Number Information
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NPI Number | 1558599159
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Entity Type | Individual
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Provider Name | THOMAS E EDWARDS III MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2009
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Last Update Date | 06/22/2012
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Provider Practice Location Address
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Address Line | 951 S BROAD ST THOMASVILLE FAMILY MEDICINE CENTER
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City | THOMASVILLE
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State | GA
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Zip | 31792-6161
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Country | US
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Telephone | 229-228-4130
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Fax | 229-226-4690
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Provider Business Mailing Address
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Address Line | 951 S BROAD ST THOMASVILLE FAMILY MEDICINE CENTER
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City | THOMASVILLE
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State | GA
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Zip | 31792-6161
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Country | US
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Telephone | 229-228-4130
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Fax | 229-226-4690
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 31723
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 067559
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License Number State | GA
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