Individual
DR. DAREL C EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
206 MAPLE DR, VIDALIA, GA 30474-8907
(912) 537-3004
(912) 537-7935
Mailing address
206 MAPLE DR, VIDALIA, GA 30474-8907
(912) 537-3004
(912) 537-7935
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
Primary
OPT001223
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00423893G
—
GA
01
—
OPT001223
STATE LICENSE
GA
Enumeration date
08/30/2005
Last updated
05/25/2012
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