Individual
DR. EDWARD J ROE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-4405
(904) 244-4508
Mailing address
655 W 8TH ST, JACKSONVILLE, FL 32209-6511
(904) 244-4405
(904) 244-4508
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00025819
AL
207P00000X
Emergency Medicine Physician
Primary
ME 118390
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051520255
BCBS PROVIDER NUMBER
AL
05
—
051520255
—
AL
01
—
P00126967
RRMC PROVIDER NUMBER
AL
Enumeration date
11/15/2005
Last updated
03/07/2023
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