Individual
DR. PAUL THOMAS EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
75 D MAIN STREET, MATHEWS, VA 23109-1270
(804) 725-2430
(804) 725-2377
Mailing address
PO BOX 1270, MATHEWS, VA 23109-1270
(804) 725-2430
(804) 725-2377
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0618000435
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009203753
—
VA
01
—
072708
ANTHEM BLUE CROSS/BLUE SH
VA
Enumeration date
08/01/2006
Last updated
03/05/2014
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