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NPI Code Detail

MEDICARE: GEORGE T EDWARDS MD

MEDICARE: GEORGE T 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
1208600000XSurgery Physician9997TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
26106933OTHERTNCIGNA
34235689OTHERTNAETNA
4202441OTHERTNBETTER HEALTH PLAN OF TN
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
661680OTHERTNBLUE CROSS OF TN
7202441OTHERTNUNISON
84139147OTHERTNBCBS

General Provider Information

NPI Number : 1245235027
Entity Type Code : Individual
Provider Name (Legal Business Name) : GEORGE T EDWARDS MD
Provider Business Mailing Address
First Line : 315 WINDY CITY RD
Second Line :
City : JACKSON
State : TN
Zip : 38305-9643
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 615 N BONITA AVE
Second Line :
City : PANAMA CITY
State : FL
Zip : 32401-3623
Country : US
Telephone Number : 850-769-1511
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 03/17/2018

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Directions to “ GEORGE T EDWARDS MD” Practice Location

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