Provider Demographics
NPI:1871879700
Name:ROBERT H. EDWARDS, MD, LLC
Entity type:Organization
Organization Name:ROBERT H. EDWARDS, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:H
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:740-537-5000
Mailing Address - Street 1:PO BOX 14397
Mailing Address - Street 2:
Mailing Address - City:POLAND
Mailing Address - State:OH
Mailing Address - Zip Code:44514-7397
Mailing Address - Country:US
Mailing Address - Phone:740-537-5000
Mailing Address - Fax:740-537-5004
Practice Address - Street 1:1800 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:TORONTO
Practice Address - State:OH
Practice Address - Zip Code:43964-1949
Practice Address - Country:US
Practice Address - Phone:740-537-5000
Practice Address - Fax:740-537-5004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-24
Last Update Date:2012-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.05918207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0062227Medicaid