Provider Demographics
NPI:1023074978
Name:KERN, EDWARD E (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:E
Last Name:KERN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3001 SCENIC HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:GADSDEN
Mailing Address - State:AL
Mailing Address - Zip Code:35904-3047
Mailing Address - Country:US
Mailing Address - Phone:256-546-9265
Mailing Address - Fax:256-549-0376
Practice Address - Street 1:2202 GATEWAY DR
Practice Address - Street 2:A
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-6870
Practice Address - Country:US
Practice Address - Phone:334-745-6125
Practice Address - Fax:334-745-8102
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL106222084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL515-22840OtherBLUE CROSS OF AL PROV #
ALI652Medicare PIN
AL515-22840OtherBLUE CROSS OF AL PROV #