# DR. ANTONIO DESSELL EDWARDS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1568515419
- **Gender:** Man
- **Credential:** M.D.

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 12515R | LA | Yes |
| 207Q00000X | Family Medicine Physician | 84438 | GA | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 12515R | LA | — |
| 207QA0401X | Addiction Medicine (Family Medicine) Physician | 84438 | GA | — |
| 405300000X | Prevention Professional | 12515R | LA | — |
| 405300000X | Prevention Professional | 84438 | GA | — |

## Other

- **Enumeration date:** 01/22/2007
- **Last updated:** 05/12/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1534358 | — | LA |