Provider Demographics
NPI:1467462382
Name:EDWARDS, STEPHEN KIRK (DC)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:KIRK
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:DC
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 283
Mailing Address - Street 2:
Mailing Address - City:CLAY
Mailing Address - State:AL
Mailing Address - Zip Code:35048
Mailing Address - Country:US
Mailing Address - Phone:205-520-0091
Mailing Address - Fax:205-520-0508
Practice Address - Street 1:6504 OLD SPRINGVILLE RD
Practice Address - Street 2:
Practice Address - City:PINSON
Practice Address - State:AL
Practice Address - Zip Code:35126-3183
Practice Address - Country:US
Practice Address - Phone:205-520-0091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2023-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1953111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-27998OtherBCBS
AL515-27998OtherBCBS
ALU76615Medicare UPIN