Individual
DR. DOUGLAS T. EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 N 1ST ST, WAUSAU, WI 54403-4754
(715) 261-8500
(715) 261-8671
Mailing address
800 N 1ST ST, WAUSAU, WI 54403-4754
(715) 261-8500
(715) 261-8671
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
45495
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002739155
MEDICARE
WI
05
—
34386000
—
WI
Enumeration date
11/25/2005
Last updated
10/07/2020
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