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General NPI Number Information
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NPI Number | 1568418549
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Entity Type | Organization
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Legal Business Name | JOHN D EDWARDS MD, INC
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Dates
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Enumeration Date | 05/25/2006
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Last Update Date | 11/30/2007
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Provider Practice Location Address
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Address Line | 7380 TURFWAY RD
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City | FLORENCE
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State | KY
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Zip | 41042-1355
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Country | US
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Telephone | 859-962-4888
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Fax | 859-962-5991
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Provider Business Mailing Address
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Address Line | PO BOX 634607
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City | CINCINNATI
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State | OH
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Zip | 45263-0001
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Country | US
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Telephone | 513-891-2813
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Fax | 513-793-1032
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Authorized Official
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Title or Position | OWNER/ PRESIDENT
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Name | DR. JOHN D EDWARDS
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Credential | MD
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Telephone | 859-962-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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