Edlin, John Charles

Edlin, John Charles is an individual health care provider with primary practice located at 12800 Hillcrest Rd Suite 216, Dallas TX 75230-1524. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Behavioral Health & Social Service Providers / Mental Health. Allopathic & Osteopathic Physicians / Adolescent Medicine is his primary health care specialty. Edlin, John Charles can be contacted via phone (972) 239-9252.

Contact Information

Primary practice address
12800 Hillcrest Rd Suite 216 Dallas TX 75230-1524
Phone: (972) 239-9252
Fax: (972) 404-9609
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 207QA0000X E1307 Texas
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X E1307 Texas
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1114936614
LBN Legal business name Edlin, John Charles
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 5th, 2006
Last updated Jul 8th, 2007 - about 17 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 1114936614 NPPES
Texas Other 886542 BLUE CROSS BLUE SHIELD

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