Provider Demographics
NPI:1841513074
Name:ALAN W EDWARDS, M.D., P.C.
Entity type:Organization
Organization Name:ALAN W EDWARDS, M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:W
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:757-562-4196
Mailing Address - Street 1:PO BOX 755
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:VA
Mailing Address - Zip Code:23851-0755
Mailing Address - Country:US
Mailing Address - Phone:757-562-4196
Mailing Address - Fax:757-562-0065
Practice Address - Street 1:118 FAIRVIEW DR STE 101
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:VA
Practice Address - Zip Code:23851-1250
Practice Address - Country:US
Practice Address - Phone:757-562-4196
Practice Address - Fax:757-562-0065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-02
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101026338207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA003055OtherANTHEM BCBS
VA6070051Medicaid
VA6070051Medicaid
112936398Medicare PIN