Edwards, Jerry L
Edwards, Jerry L is an individual health care provider with primary practice located at 3412 Staunton Ave Se , Charleston WV 25304-1327. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Edwards, Jerry L can be contacted via phone (304) 388-6004.Contact Information
Primary practice address
3412 Staunton Ave Se
Charleston WV 25304-1327
Phone: (304) 388-6004
Fax: (304) 388-3360
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | DO1265 | Tennessee |
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 851 | West Virginia |
Profile Details
| NPI number | 1457321820 |
|---|---|
| LBN Legal business name | Edwards, Jerry L |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 26th, 2006 |
| Last updated | Oct 19th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457321820 | NPPES |
| Tennessee | MEDICAID | 3305715 | |
| Tennessee | Other | 4078407 | |
| Tennessee | Other | 930077458 |
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