Individual
JOHNATHON CURTIS EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 E PARRISH AVE, BLDG E SUITE 205, OWENSBORO, KY 42303-1449
(270) 852-1645
(270) 852-1646
Mailing address
2200 E PARRISH AVE, BLDG E SUITE 205, OWENSBORO, KY 42303-1449
(270) 852-1645
(270) 852-1646
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
39536
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000489532
ANTHEM
KY
05
—
64127699
—
KY
Enumeration date
06/12/2006
Last updated
03/27/2010
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