MEDICARE: JERRY L EDWARDS DO

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	207P00000X	Emergency Medicine Physician	DO1265	TN
2	207P00000X	Emergency Medicine Physician	851	WV

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	930077458	OTHER		RAILROAD MEDICARE

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	4078407	OTHER		BCBS PROVIDER

General Provider Information

NPI Number	:	1457321820
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERRY L EDWARDS DO

Provider Business Mailing Address
First Line	:	3412 STAUNTON AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1327
Country	:	US
Telephone Number	:	304-388-6004
Fax Number	:	304-388-3360

Provider Business Practice Location Address
First Line	:	3412 STAUNTON AVE SE
Second Line	:
City	:	CHARLESTON
State	:	WV
Zip	:	25304-1327
Country	:	US
Telephone Number	:	304-388-6004
Fax Number	:	304-388-3360

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	10/19/2018

Similar Medicare Providers

1659574382 — KANAWHA VALLEY INTERNAL MEDICINE PLLC
Practice Location Address:

3418 STAUNTON AVE SE
CHARLESTON, WV
25304-1327

Practice Phone: 304-720-3600
Practice Fax:

1386084507 — JOSEPH LAWRENCE WONSETTLER PA-C
Practice Location Address:

3412 STAUNTON AVE SE
CHARLESTON, WV
25304-1327

Practice Phone: 304-388-6004
Practice Fax: 304-388-3360

1104461664 — RYAN F. CHAMBERS PA-C
Practice Location Address:

3412 STAUNTON AVE SE
CHARLESTON, WV
25304-1327

Practice Phone: 304-000-0000
Practice Fax:

1417710781 — HOLLY HALDAN HERR PA
Practice Location Address:

1327 ASHLEY RIVER RD
CHARLESTON, SC
29407-5384

Practice Phone: 843-577-4551
Practice Fax:

1912974023 — DR. ZACHARY M ARTHURS MD
Practice Location Address:

1327 ASHLEY RIVER RD
CHARLESTON, SC
29407-5384

Practice Phone: 843-577-4551
Practice Fax: 843-577-8868

1114930021 — DR. KRISTIAN O. HOCHBERG M.D.
Practice Location Address:

1327 ASHLEY RIVER RD
CHARLESTON, SC
29407-5384

Practice Phone: 843-577-4551
Practice Fax:

Directions to “ JERRY L EDWARDS DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.