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Individual

DR. KENNY B EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
670 LEIGH DRIVE, COLUMBUS, MS 39705
(662) 328-1012
(662) 328-1507
Mailing address
670 LEIGH DRIVE, COLUMBUS, MS 39705
(662) 328-1012
(662) 328-1507

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
21545
MS
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
21545
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00776741
MS
Enumeration date
03/14/2007
Last updated
10/07/2022
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