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1174631113

NPI Code Detail

MEDICARE: JAMES EUGENE EDWARDS MD

MEDICARE: JAMES EUGENE 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	2084P0800X	Psychiatry Physician	ME142617	FL
2	2084P0800X	Psychiatry Physician	16229	SC
3	2084P0804X	Child & Adolescent Psychiatry Physician	042-0015754	VT
4	2084P0804X	Child & Adolescent Psychiatry Physician	314619	NY
5	2084P0804X	Child & Adolescent Psychiatry Physician	16229	SC
6	2084P0804X	Child & Adolescent Psychiatry Physician	86746	GA
7	2084P0804X	Child & Adolescent Psychiatry Physician	ME142617	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1174631113
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES EUGENE EDWARDS MD

Provider Business Mailing Address
First Line	:	601 E 66TH ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4519
Country	:	US
Telephone Number	:	912-662-0088
Fax Number	:	912-264-0979

Provider Business Practice Location Address
First Line	:	601 E 66TH ST
Second Line	:
City	:	SAVANNAH
State	:	GA
Zip	:	31405-4519
Country	:	US
Telephone Number	:	912-662-0088
Fax Number	:	912-264-0979

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

Provider Enumeration Date	:	08/29/2006
Last Update Date	:	03/11/2022

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Directions to “ JAMES EUGENE EDWARDS MD” Practice Location

Language	Start Address	Practice Location

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