Provider Demographics
NPI:1639137722
Name:EDWARDS, ROBERT NORFLEET (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NORFLEET
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 1:4509 S 6TH ST
Mailing Address - Street 2:STE 311
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97603-4880
Mailing Address - Country:US
Mailing Address - Phone:541-882-2426
Mailing Address - Fax:541-882-2362
Practice Address - Street 1:4509 S 6TH ST
Practice Address - Street 2:STE 311
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97603-4880
Practice Address - Country:US
Practice Address - Phone:541-882-2426
Practice Address - Fax:541-882-2362
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14941207ZH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZH0000XAllopathic & Osteopathic PhysiciansPathologyHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR053327Medicaid
OR053327Medicaid
ORE59245Medicare UPIN
OR0000WBGPXMedicare ID - Type UnspecifiedMEDICARE PROVIDER ID