Individual
GREGORY THOMAS EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
5108 SANDY LN, FAIRFIELD, OH 45014-2738
(866) 934-7450
Mailing address
4600 MONTGOMERY RD STE 400, CINCINNATI, OH 45212-2600
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.005085RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0235308
—
OH
Enumeration date
07/06/2017
Last updated
09/16/2025
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