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Individual

ALETHA LAKAY EDISON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
7583 WALL TRIANA HWY, MADISON, AL 35757-8327
(256) 547-6119
(256) 546-2981
Mailing address
PO BOX 303, GADSDEN, AL 35902-0303
(256) 547-6119
(256) 546-2981

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
00024685
AL
207Q00000X
Family Medicine Physician
Primary
00024685
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051513810
BCBS
AL
05
051553015
AL
01
51002018
BLUE CROSS BLUE SHIELD
AL
01
51537577
BLUE CROSS BLUE SHIELD
AL
Enumeration date
09/15/2005
Last updated
05/22/2008
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