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General NPI Number Information
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NPI Number | 1871565762
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Entity Type | Individual
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Provider Name | EDWARD M BARKSDALE JR. MD
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Gender | Male
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Dates
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Enumeration Date | 02/03/2006
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 11100 EUCLID AVENUE
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City | CLEVELAND
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State | OH
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Zip | 44106
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Country | US
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Telephone | 216-844-7874
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Fax |
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Provider Business Mailing Address
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Address Line | 24701 EUCLID AVE 3RD FLOOR
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City | EUCLID
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State | OH
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Zip | 44117-1714
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Country | US
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Telephone |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | MD053529L
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 35-090195
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 2086S0120X
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Taxonomy Name | Pediatric Surgery Physician
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License Number | 036.171546
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License Number State | IL
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