Edmondson, Michael Lee
Edmondson, Michael Lee is an individual health care provider with primary practice located at 1006 Greenfield Dr , Tifton GA 31794-3794. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Edmondson, Michael Lee can be contacted via phone (229) 382-8822.Contact Information
Primary practice address
1006 Greenfield Dr
Tifton GA 31794-3794
Phone: (229) 382-8822
Fax: (229) 387-0377
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 022542 | Georgia |
Profile Details
| NPI number | 1326056797 |
|---|---|
| LBN Legal business name | Edmondson, Michael Lee |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 3rd, 2006 |
| Last updated | Aug 22nd, 2013 - about 11 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 | 1326056797 | NPPES |
| Georgia | MEDICAID | 00223462C |
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