Individual
EDWIN L PAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 10TH AVE STE 211, COLUMBUS, GA 31901-3604
(706) 324-6661
(706) 494-3008
Mailing address
PO BOX 370, FORTSON, GA 31808-0370
(706) 494-3071
(706) 494-3008
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
041635
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000698959
—
GA
01
—
04BDBPV
MEDICARE PTAN
GA
05
—
114086
—
AL
Enumeration date
02/17/2006
Last updated
12/02/2019
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