Organization
DAREL C. EDWARDS, P.C.
Active
Other names
Vidalia EyeCare Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAREL CALVIN EDWARDS O.D. (OWNER)
(912) 537-2020
Entity
Organization
Contact information
Practice address
206 MAPLE DR, VIDALIA, GA 30474-8907
(912) 537-2020
(912) 537-7935
Mailing address
206 MAPLE DR, VIDALIA, GA 30474-8907
(912) 537-2020
(912) 537-7935
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1223
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00423893G
—
GA
01
—
1639162175
NPI INDIVIDUAL
GA
01
—
GRP3934
MEDICARE GROUP NUMBER
GA
Enumeration date
12/07/2007
Last updated
12/07/2007
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