Provider Demographics
NPI:1174631113
Name:EDWARDS, JAMES EUGENE (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:EUGENE
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 1:601 E 66TH ST
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31405-4519
Mailing Address - Country:US
Mailing Address - Phone:912-662-0088
Mailing Address - Fax:912-264-0979
Practice Address - Street 1:601 E 66TH ST
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31405-4519
Practice Address - Country:US
Practice Address - Phone:912-662-0088
Practice Address - Fax:912-264-0979
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1426172084P0800X, 2084P0804X
SC162292084P0800X, 2084P0804X
VT042-00157542084P0804X
NY3146192084P0804X
GA867462084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC162291Medicaid
FL104975300Medicaid
SC162291Medicaid