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General NPI Number Information
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NPI Number | 1710921119
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Entity Type | Individual
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Provider Name | JEFFREY L. EDWARDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/15/2006
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Last Update Date | 03/25/2010
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Provider Practice Location Address
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Address Line | 10020 NICHOLAS ST STE 106
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City | OMAHA
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State | NE
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Zip | 68114-2189
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Country | US
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Telephone | 402-894-9990
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Fax | 402-884-0129
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Provider Business Mailing Address
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Address Line | P.O. BOX 45771
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City | OMAHA
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State | NE
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Zip | 68145-0771
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Country | US
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Telephone | 402-894-9990
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Fax | 402-884-0129
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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 | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | 16977
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License Number State | NE
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