MEDICARE: DR. TOM N EDWARDS MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	9313	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0112865	OTHER	AL	UNITED HEALTH CARE
2	P00139033	OTHER	AL	RAILROAD MCARE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033187356
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TOM N EDWARDS MD

Provider Business Mailing Address
First Line	:	4614 CARNEGIE AVE
Second Line	:
City	:	FAIRFIELD
State	:	AL
Zip	:	35064-1430
Country	:	US
Telephone Number	:	205-785-1353
Fax Number	:	205-785-3731

Provider Business Practice Location Address
First Line	:	4614 CARNEGIE AVE
Second Line	:
City	:	FAIRFIELD
State	:	AL
Zip	:	35064-1430
Country	:	US
Telephone Number	:	205-785-1353
Fax Number	:	205-785-3731

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2006
Last Update Date	:	11/28/2011

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