Provider Demographics
NPI:1083805675
Name:PAXTON, EDWARD SCOTT JR (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:SCOTT
Last Name:PAXTON
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 1119
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02901-1119
Mailing Address - Country:US
Mailing Address - Phone:401-457-2157
Mailing Address - Fax:401-457-2141
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:401-457-2157
Practice Address - Fax:401-457-2141
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2007017133207X00000X
RI14290207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery