Individual
JON H EDWARDS
Active
Individual
JON H EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
130277
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00729680
—
NY
05
—
124078
—
AZ
05
—
2650215
—
OH
01
—
34195845144193
TRICARE WEST
—
05
—
7201480
—
SD
01
—
784T9
BCBS
NY
05
—
807444100
—
ID
01
—
P00285375
RXR MEDICARE
NY
Enumeration date
11/10/2005
Last updated
05/05/2014
Update your record
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