# JOHN D EDWARDS MD, INC

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

## Provider details

- **NPI number:** 1568418549
- **Authorized official:** DR. JOHN D EDWARDS MD (OWNER/ PRESIDENT)
- **Authorized official phone:** (859) 962-4888

## Contact information

- **Practice address:** 7380 TURFWAY RD, FLORENCE, KY 41042-1355
- **Practice address phone:** (859) 962-4888
- **Practice address fax:** (859) 962-5991
- **Mailing address:** PO BOX 634607, CINCINNATI, OH 45263-0001
- **Mailing address phone:** (513) 891-2813
- **Mailing address fax:** (513) 793-1032

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208600000X | Surgery Physician | — | NULL | — |
| 208600000X | Surgery Physician | — | — | — |
| 2086S0129X | Vascular Surgery Physician | — | NULL | Yes |
| 2086S0129X | Vascular Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/25/2006
- **Last updated:** 11/30/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 2688846 | — | OH |
| 05 | — | 65946063 | — | KY |
| 01 | — | DC9797 | RR MEDICARE | OH |