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NPI Code Detail

MEDICARE: JONATHAN SCOTT EDWARDS

MEDICARE:   JONATHAN SCOTT EDWARDS
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
1247200000XOther Technician

General Provider Information

NPI Number : 1366553158
Entity Type Code : Individual
Provider Name (Legal Business Name) : JONATHAN SCOTT EDWARDS
Provider Business Mailing Address
First Line : PO BOX 7133
Second Line :
City : BELLE CHASSE
State : LA
Zip : 70037-7133
Country : US
Telephone Number : 504-556-8118
Fax Number :
Provider Business Practice Location Address
First Line : 13800 OLD GENTILLY RD
Second Line :
City : NEW ORLEANS
State : LA
Zip : 70129-2218
Country : US
Telephone Number : 504-556-8118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 07/08/2007

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Directions to “ JONATHAN SCOTT EDWARDS ” Practice Location

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