# DR. JOHN D EDWARDS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1124079249
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2086S0129X | Vascular Surgery Physician | 0101249785 | VA | — |
| 2086S0129X | Vascular Surgery Physician | 036139185 | IL | Yes |
| 2086S0129X | Vascular Surgery Physician | 35-072723 | OH | — |
| 2086S0129X | Vascular Surgery Physician | 38823 | KY | — |

## Other

- **Enumeration date:** 05/13/2006
- **Last updated:** 04/28/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000609662 | ANTHEM - NVA | KY |
| 01 | — | 000023035Y | HUMANA - CTS (NVA) | KY |
| 01 | — | 00533123 | MEDICARE KY - CTS (NVA) | KY |
| 01 | — | 103475 | SIHO - NVA | KY |
| 05 | — | 200164020 | — | IN |
| 05 | — | 2040375 | — | OH |
| 01 | — | 3709852000 | PASSPORT ADVTG - NVA | KY |
| 01 | — | 50011792 | PASSPORT - NVA | KY |
| 01 | — | 6286669 | CIGNA - NVA | KY |
| 05 | — | 64960628 | — | KY |
| 01 | — | P00201740 | RR MEDICARE | OH |
| 01 | — | P00733104 | RR MCR-KY (NVA) | KY |