Individual
DR. R DOUGLAS EDWARDS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3807 FREEDOM WAY, LOUISVILLE, KY 40229
(502) 969-3205
(520) 969-8306
Mailing address
3807 FREEDOM WAY, LOUISVILLE, KY 40229
(502) 969-3205
(520) 969-8306
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4050
KY
1223G0001X
General Practice Dentistry
4050
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60040508
—
KY
Enumeration date
02/16/2007
Last updated
04/09/2015
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