Edmonson, George R

Edmonson, George R is an individual health care provider with primary practice located at 166 4Th St E , Saint Paul MN 55101-1421. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Edmonson, George R can be contacted via phone (651) 292-2043.

Contact Information

Primary practice address
166 4Th St E Saint Paul MN 55101-1421
Phone: (651) 292-2043
Fax: (651) 292-2204
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 28504 Minnesota
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 28504 Minnesota

Profile Details

NPI number 1851379069
LBN Legal business name Edmonson, George R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 6th, 2006
Last updated Jun 9th, 2010 - about 14 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 1851379069 NPPES
Minnesota MEDICAID 648018700

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