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NPI Code Detail

MEDICARE: DARREN SCOTT EDSON MD

MEDICARE: DARREN SCOTT EDSON 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
1207P00000XEmergency Medicine PhysicianP5799TX
2207P00000XEmergency Medicine Physician036142351IL
3207P00000XEmergency Medicine Physician5382NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1214881OTHERILMEDICARE OSCAR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3036.142351OTHERILBCBSIL

General Provider Information

NPI Number : 1699777391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARREN SCOTT EDSON MD
Provider Business Mailing Address
First Line : 500 N RAINBOW BLVD
Second Line : #203
City : LAS VEGAS
State : NV
Zip : 89107-1082
Country : US
Telephone Number : 702-259-1228
Fax Number : 702-259-1252
Provider Business Practice Location Address
First Line : 405 W JACKSON ST
Second Line :
City : CARBONDALE
State : IL
Zip : 62901-1462
Country : US
Telephone Number : 618-549-0721
Fax Number : 618-457-0469
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2005
Last Update Date : 05/16/2025

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