Provider Demographics
NPI:1487845665
Name:EDWARDS, JAIME MARGUERITE (MD)
Entity Type:Individual
Prefix:DR
First Name:JAIME
Middle Name:MARGUERITE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 3087
Mailing Address - Street 2:
Mailing Address - City:HAMMOND
Mailing Address - State:LA
Mailing Address - Zip Code:70404-3087
Mailing Address - Country:US
Mailing Address - Phone:985-230-1682
Mailing Address - Fax:985-230-6652
Practice Address - Street 1:15813 PAUL VEGA MD DR
Practice Address - Street 2:SUITE 200
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-1495
Practice Address - Country:US
Practice Address - Phone:985-230-7650
Practice Address - Fax:985-230-7655
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10029595207V00000X
LAMD.205009207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2174185Medicaid
4664134417OtherMYUTMB 4664134417