# EDMONDS MEDICAL, LLC

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

## Provider details

- **NPI number:** 1477792844
- **Authorized official:** HOLLY L EDMONDS PA-C (PRESIDENT)
- **Authorized official phone:** (225) 810-3430

## Contact information

- **Practice address:** 3111 LONGLEAF CT, BATON ROUGE, LA 70810-0308
- **Practice address phone:** (225) 810-3430
- **Mailing address:** 5445 LA SIERRA DR, SUITE 410, DALLAS, TX 75231-4139
- **Mailing address phone:** (214) 382-1909
- **Mailing address fax:** (214) 382-1903

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | A10599 | LA | Yes |

## Other

- **Enumeration date:** 02/09/2009
- **Last updated:** 02/09/2009