Individual
JAMES BENNETT EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
503 EISENHOWER DR, SAVANNAH, GA 31406
(912) 355-6255
(912) 644-5260
Mailing address
210 E DERENNE AVE, ATTN: PROVIDER ENROLLMENT, SAVANNAH, GA 31405-6736
(912) 644-5300
(912) 644-5260
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
041784
GA
2085N0700X
Neuroradiology Physician
041784
GA
2085N0904X
Nuclear Radiology Physician
041784
GA
2085P0229X
Pediatric Radiology Physician
041784
GA
2085R0202X
Diagnostic Radiology Physician
Primary
041784
GA
2085U0001X
Diagnostic Ultrasound Physician
041784
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000702039
—
GA
01
—
010571
BCBS GA
GA
05
—
G41784-SR
—
SC
01
—
P00334794
RAILROAD MEDICARE-SCI
GA
01
—
P00857151
RR MCARE-OIS
GA
Enumeration date
09/09/2005
Last updated
08/29/2018
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