MEDICARE: DR. TAYLOR WATKINS EDWARDS OD

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	152W00000X	Optometrist	1051P-Y	MS

General Provider Information

NPI Number	:	1548995509
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TAYLOR WATKINS EDWARDS OD

Provider Business Mailing Address
First Line	:	PO BOX 608
Second Line	:
City	:	WATER VALLEY
State	:	MS
Zip	:	38965-0608
Country	:	US
Telephone Number	:	662-473-2181
Fax Number	:	662-473-2161

Provider Business Practice Location Address
First Line	:	302 RAILROAD ST
Second Line	:
City	:	WATER VALLEY
State	:	MS
Zip	:	38965-3032
Country	:	US
Telephone Number	:	662-473-2181
Fax Number	:	662-473-2161

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

Provider Enumeration Date	:	07/22/2022
Last Update Date	:	11/03/2025

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