Edwards, Jacob

Edwards, Jacob is an individual health care provider with primary practice located at 5565 Montgomery Hwy , Dothan AL 36303-1552. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Edwards, Jacob can be contacted via phone (334) 699-3733.

Contact Information

Primary practice address
5565 Montgomery Hwy Dothan AL 36303-1552
Phone: (334) 699-3733
Fax: (334) 500-3007
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD.31940 Alabama

Profile Details

NPI number 1730323254
LBN Legal business name Edwards, Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 28th, 2009
Last updated May 15th, 2020 - about 5 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 1730323254 NPPES
Georgia MEDICAID 003190111D
Georgia MEDICAID 021006600
Georgia MEDICAID 141478
Georgia MEDICAID 229200
Georgia Other 51222367

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