Provider Demographics
NPI:1932145117
Name:EDWARDS, RODNEY KIRK (MD)
Entity Type:Individual
Prefix:
First Name:RODNEY
Middle Name:KIRK
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:RODNEY
Other - Middle Name:K
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 100294
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32610-0294
Mailing Address - Country:US
Mailing Address - Phone:352-273-7584
Mailing Address - Fax:352-392-3498
Practice Address - Street 1:1600 SW ARCHER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32610-4637
Practice Address - Country:US
Practice Address - Phone:352-273-7584
Practice Address - Fax:352-392-3498
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME72732207V00000X
AL31258207VM0101X
OK31964207VM0101X
FLME164577207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL255852100Medicaid
FL68954Medicare ID - Type Unspecified
G90332Medicare UPIN