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NPI Code Detail

MEDICARE: DR. BRENT S EDWARDS M.D.

MEDICARE:  DR. BRENT S EDWARDS  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
1174400000XSpecialist039781GA

General Provider Information

NPI Number : 1346225489
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRENT S EDWARDS M.D.
Provider Business Mailing Address
First Line : 3614 J DEWEY GRAY CIR STE A
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6512
Country : US
Telephone Number : 706-922-9222
Fax Number : 706-922-5766
Provider Business Practice Location Address
First Line : 3614 J DEWEY GRAY CIR STE A
Second Line :
City : AUGUSTA
State : GA
Zip : 30909-6512
Country : US
Telephone Number : 706-922-9222
Fax Number : 706-922-5766
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 07/20/2011

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Directions to “ DR. BRENT S EDWARDS M.D.” Practice Location

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