# EDWARDS FAMILY MEDICINE A PROFESSIONAL MEDICAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164203931
- **Authorized official:** RICHARD EARL EDWARDS MD (OWNER)
- **Authorized official phone:** (337) 824-2282

## Contact information

- **Practice address:** 1322 ELTON RD STE P, JENNINGS, LA 70546-4100
- **Practice address phone:** (337) 824-2282
- **Practice address fax:** (337) 824-0058
- **Mailing address:** 1322 ELTON RD STE P, JENNINGS, LA 70546-4100
- **Mailing address phone:** (337) 824-2282
- **Mailing address fax:** (337) 824-0058

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/09/2023
- **Last updated:** 10/09/2023