Individual
DR. EDWARD JOSEPH LOPEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M
Contact information
Practice address
705 17TH ST, COLUMBUS, GA 31901-3500
(706) 322-7884
(706) 243-4355
Mailing address
PO BOX 9247, COLUMBUS, GA 31908-9247
(706) 322-7884
(706) 243-4345
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000814
GA
213E00000X
Podiatrist
1541
TX
213E00000X
Podiatrist
246
AL
213E00000X
Podiatrist
E-3603
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000750439O
—
GA
01
—
202I501203
MEDICARE PTAN
GA
01
—
814
STATE ID
GA
Enumeration date
09/27/2006
Last updated
12/17/2021
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