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General NPI Number Information
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NPI Number | 1659338317
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Entity Type | Organization
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Legal Business Name | ROBERT N EDWARDS JR MD
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4509 S 6TH ST STE. 311
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City | KLAMATH FALLS
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State | OR
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Zip | 97603-4880
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Country | US
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Telephone | 541-882-2426
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Fax | 541-882-2362
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Provider Business Mailing Address
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Address Line | 4509 S 6TH ST STE. 311
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City | KLAMATH FALLS
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State | OR
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Zip | 97603-4880
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Country | US
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Telephone | 541-882-2426
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Fax | 541-882-2362
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROBERT NORFLEET EDWARDS
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Credential | M.D.
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Telephone | 541-882-2426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 366
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License Number State | OR
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