Provider Demographics
NPI:1477521086
Name:EDWARDS, JAMES HERRON (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:HERRON
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 153
Mailing Address - Street 2:
Mailing Address - City:FISHERSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22939-0153
Mailing Address - Country:US
Mailing Address - Phone:540-221-6723
Mailing Address - Fax:540-221-6748
Practice Address - Street 1:342 MULE ACADEMY RD
Practice Address - Street 2:
Practice Address - City:FISHERSVILLE
Practice Address - State:VA
Practice Address - Zip Code:22939-2256
Practice Address - Country:US
Practice Address - Phone:540-221-6723
Practice Address - Fax:540-221-6748
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101245058207QA0505X
FLME42113207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL370634600Medicaid
D64874Medicare UPIN