Edwards, Antonio Dessell
Edwards, Antonio Dessell is an sole proprietor health care provider with primary practice located at 25073 Highway 1 S , Plaquemine LA 70764-4431. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Addiction Medicine, Other Service Providers / Prevention Professional, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Edwards, Antonio Dessell can be contacted via phone (225) 687-1772.Contact Information
Primary practice address
25073 Highway 1 S
Plaquemine LA 70764-4431
Phone: (225) 687-1772
Fax: (225) 687-1013
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 84438 | Georgia |
Other Service Providers / Prevention Professional | 405300000X | 12515R | Louisiana |
Other Service Providers / Prevention Professional | 405300000X | 84438 | Georgia |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 12515R | Louisiana |
Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 84438 | Georgia |
Allopathic & Osteopathic Physicians / Addiction Medicine | 207QA0401X | 12515R | Louisiana |
Profile Details
NPI number | 1568515419 |
---|---|
LBN Legal business name | Edwards, Antonio Dessell |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 22nd, 2007 |
Last updated | May 12th, 2020 - about 4 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 | 1568515419 | NPPES |
Louisiana | MEDICAID | 1534358 |
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