Individual
DR. WAYNE R. EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6500 HIGHWAY 645, SUITE 110, INEZ, KY 41224
(606) 534-4002
(606) 534-4007
Mailing address
142 QUAIL WALK, PIKEVILLE, KY 41501-1430
(606) 253-3045
(606) 432-4050
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
34226
KY
207QA0000X
Adolescent Medicine (Family Medicine) Physician
34226
KY
207QA0401X
Addiction Medicine (Family Medicine) Physician
34226
KY
207QA0505X
Adult Medicine Physician
34226
KY
2084P0802X
Addiction Psychiatry Physician
Primary
34226
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000297028
ANTHEM BC/BS
KY
05
—
64050271
—
KY
Enumeration date
08/08/2006
Last updated
08/31/2021
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