Edwards, Darel C

Edwards, Darel C is an sole proprietor health care provider with primary practice located at 206 Maple Dr , Vidalia GA 30474-8907. He recently has only one registered license in Eye and Vision Services Providers / Corneal and Contact Management, which is considered as his primary health care specialty. Edwards, Darel C can be contacted via phone (912) 537-3004.

Contact Information

Primary practice address
206 Maple Dr Vidalia GA 30474-8907
Phone: (912) 537-3004
Fax: (912) 537-7935
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Corneal and Contact Management 152WC0802X OPT001223 Georgia

Profile Details

NPI number 1639162175
LBN Legal business name Edwards, Darel C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2005
Last updated May 25th, 2012 - about 13 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 1639162175 NPPES
Georgia MEDICAID 00423893G
Georgia Other OPT001223

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