Individual
EDWARD JOHNSON JONES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 EXECUTIVE PARKWAY, MONCKS CORNER, SC 29461
(843) 761-2815
(843) 869-8034
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
(843) 569-5879
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22048
SC
208000000X
Pediatrics Physician
22048
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080157309
MEDICARE RAIL ROAD
SC
05
—
AA59077126
—
SC
05
—
T62189
—
SC
Enumeration date
05/17/2006
Last updated
06/29/2021
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