Edmundson, Alan Wayne

Edmundson, Alan Wayne is an individual health care provider with primary practice located at Bldg 2441 2441 21St Street, Fort Campbell KY 42223-5369. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Edmundson, Alan Wayne can be contacted via phone (270) 798-8614.

Contact Information

Primary practice address
Bldg 2441 2441 21St Street Fort Campbell KY 42223-5369
Phone: (270) 798-8614
Fax: (270) 798-8633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 3475 Tennessee
Dental Providers / General Practice 1223G0001X 3475 Tennessee

Profile Details

NPI number 1710954755
LBN Legal business name Edmundson, Alan Wayne
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 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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