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General NPI Number Information
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NPI Number | 1912100819
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Entity Type | Individual
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Provider Name | JAMES ALEXANDER EDMOND MD
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Gender | Male
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Dates
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Enumeration Date | 06/07/2007
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Last Update Date | 09/30/2008
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Provider Practice Location Address
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Address Line | 3 CEMETERY RD
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3217
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Country | US
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Telephone | 518-944-4292
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Fax |
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Provider Business Mailing Address
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Address Line | 6 CINNAMON LN
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City | CLIFTON PARK
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State | NY
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Zip | 12065-2684
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Country | US
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Telephone | 518-944-4202
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 141147-1
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License Number State | NY
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