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NPI Code Detail

MEDICARE: EDWARD WESLEY KNOWLES M.D.

MEDICARE: EDWARD WESLEY KNOWLES M.D.
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
1208600000XSurgery Physician17019AL
2207P00000XEmergency Medicine Physician17019AL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
251000144OTHERALBLUE CROSS

General Provider Information

NPI Number : 1114925815
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD WESLEY KNOWLES M.D.
Provider Business Mailing Address
First Line : 911 S BROAD ST
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-2509
Country : US
Telephone Number : 256-259-0185
Fax Number : 256-259-0317
Provider Business Practice Location Address
First Line : 911 S BROAD ST
Second Line :
City : SCOTTSBORO
State : AL
Zip : 35768-2509
Country : US
Telephone Number : 256-259-0185
Fax Number : 256-259-0317
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 09/04/2014

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