Organization
JOHN D EDWARDS MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D EDWARDS MD (OWNER/ PRESIDENT)
(859) 962-4888
Entity
Organization
Contact information
Practice address
7380 TURFWAY RD, FLORENCE, KY 41042-1355
(859) 962-4888
(859) 962-5991
Mailing address
PO BOX 634607, CINCINNATI, OH 45263-0001
(513) 891-2813
(513) 793-1032
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2688846
—
OH
05
—
65946063
—
KY
01
—
DC9797
RR MEDICARE
OH
Enumeration date
05/25/2006
Last updated
11/30/2007
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