Organization
MIRANDA Y. EDWARDS, M.D LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS CHANDRA LYNNETTE EDWARDS (BUSINESS MANAGER)
(706) 243-2900
Entity
Organization
Contact information
Practice address
500 18TH ST, SUITE A-10, COLUMBUS, GA 31901-1536
(706) 243-2900
(706) 243-2903
Mailing address
PO BOX 4173, COLUMBUS, GA 31914-0173
(706) 243-2900
(706) 243-2903
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049971
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP6934
MEDICARE GROUP#
GA
Enumeration date
07/18/2007
Last updated
02/15/2011
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