Individual
MR. JUSTIN G. EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
979 E 3RD ST STE C225, CHATTANOOGA, TN 37403-3314
(423) 778-5995
(423) 778-3445
Mailing address
979 E 3RD ST STE C225, CHATTANOOGA, TN 37403-3314
(423) 778-5995
(423) 778-3445
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA2874
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA2874
MEDICAL LICENSE
TN
Enumeration date
08/22/2014
Last updated
12/27/2019
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