Provider Demographics
NPI:1033106976
Name:EDWARDS, PRESTON HILL (MD)
Entity Type:Individual
Prefix:DR
First Name:PRESTON
Middle Name:HILL
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1337
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-1337
Mailing Address - Country:US
Mailing Address - Phone:276-236-3210
Mailing Address - Fax:276-236-8780
Practice Address - Street 1:702 PINE ST
Practice Address - Street 2:
Practice Address - City:HILLSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24343-1405
Practice Address - Country:US
Practice Address - Phone:276-728-4311
Practice Address - Fax:276-728-0901
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026339207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010108250Medicaid
VA010108250Medicaid
VA00X502H01Medicare PIN