Individual
JOHN RAY EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
118 PINE ST, BURLINGTON, VT 05401-8421
(802) 658-2767
(802) 862-4062
Mailing address
118 PINE ST, BURLINGTON, VT 05401-8421
(802) 658-2767
(802) 862-4062
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
042-0005157
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005380
—
VT
Enumeration date
03/17/2007
Last updated
04/10/2010
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