Edwards, Antonio Dessell

Edwards, Antonio Dessell is an sole proprietor health care provider with primary practice located at 25073 Highway 1 S , Plaquemine LA 70764-4431. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Other Service Providers / Prevention Professional, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Edwards, Antonio Dessell can be contacted via phone (225) 687-1772.

Contact Information

Primary practice address
25073 Highway 1 S Plaquemine LA 70764-4431
Phone: (225) 687-1772
Fax: (225) 687-1013
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 84438 Georgia
Other Service Providers / Prevention Professional 405300000X 12515R Louisiana
Other Service Providers / Prevention Professional 405300000X 84438 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 12515R Louisiana
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 84438 Georgia
Allopathic & Osteopathic Physicians / Addiction Medicine 207QA0401X 12515R Louisiana

Profile Details

NPI number 1568515419
LBN Legal business name Edwards, Antonio Dessell
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 22nd, 2007
Last updated May 12th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568515419 NPPES
Louisiana MEDICAID 1534358

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