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General NPI Number Information
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NPI Number | 1912468372
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Entity Type | Individual
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Provider Name | ERIC DEWARD EDDY MD
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Gender | Male
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Dates
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Enumeration Date | 03/28/2019
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Last Update Date | 04/01/2025
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Provider Practice Location Address
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Address Line | 208 MEDICAL PARK BLVD
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City | BRISTOL
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State | TN
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Zip | 37620-7343
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Country | US
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Telephone | 423-989-4050
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Fax | 423-990-3044
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Provider Business Mailing Address
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Address Line | 2700 SE STRATUS AVE # 301
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City | MCMINNVILLE
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State | OR
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Zip | 97128-6239
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Country | US
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Telephone | 971-901-3908
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Fax | 503-472-4418
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD211856
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License Number State | OR
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