Organization
WB EDWARDS MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILSON BARTON EDWARDS JR. M.D. (OWNER)
(850) 250-3360
Entity
Organization
Contact information
Practice address
1607 LISENBY AVE, SUITE D, PANAMA CITY, FL 32405-3796
(850) 250-3360
(850) 640-3798
Mailing address
1607 LISENBY AVE, SUITE D, PANAMA CITY, FL 32405-3796
(850) 250-3360
(850) 640-3798
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
ME65288
FL
2084P0800X
Psychiatry Physician
Primary
ME65288
FL
Other
Enumeration date
01/19/2017
Last updated
03/15/2017
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