Individual
JEFFERSON EDGINGTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-C
Contact information
Practice address
1412 ELBA HWY, TROY, AL 36079-6020
(334) 566-8822
(334) 670-6723
Mailing address
1414 ELBA HWY, TROY, AL 36079-6020
(334) 670-6726
(334) 670-6731
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-097146
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-097146
STATE LICENSE
AL
05
—
157918
—
AL
Enumeration date
02/18/2014
Last updated
05/15/2017
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