Individual
DR. EDWARD J WREN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1100 ANDRE ST, SUITE 300, NEW IBERIA, LA 70563-2159
(337) 364-9225
(337) 364-6094
Mailing address
PO BOX 20452, YPS-CRED, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
015754
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1311111
—
LA
01
—
1427191790
BCBS OF LA
LA
Enumeration date
02/15/2007
Last updated
08/26/2013
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