Charles Douglas Edmondson in El Dorado - Specialist
Charles Douglas Edmondson - NPI 1669589040
Charles Douglas Edmondson is a Specialist in El Dorado, Arkansas. Charles Douglas Edmondson practices all healthcare services and medical treatments related to Specialist. The NPI Number for Charles Douglas Edmondson is 1669589040. The last update date is 2007-10-15.
Charles Douglas Edmondson's current location address is 611 Thompson Ave, El Dorado, Arkansas. You can contact this provider via phone number 8708621577 and fax number 8708625916. The mailing address for Charles Douglas Edmondson is 611 Thompson Ave, El Dorado, Arkansas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charles Douglas Edmondson |
|---|---|
| Address | 611 Thompson Ave, El Dorado, Arkansas |
| Phone Number | 8708621577 |
| Fax Number | 8708625916 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1669589040 |
|---|---|
| Provider Enumeration Date | 2006-08-23 |
| Last Updated Date | 2007-10-15 |
Provider Mailing Address Detail
| Address | 611 Thompson Ave |
|---|---|
| City | El Dorado |
| State | Arkansas (AR) |
| Post Code | 717304557 |
| Phone Number | 8708621577 |
| Fax Number | 8708625916 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | C5187 |
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Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 710813069 | AR | FED. TAX ID # | |
| 134936001 | AR | -- | |
| C5187 | AR | MEDICAL ST. LICENSE # | |
| 5C070 | AR | GRP'S MCARE PROV.# |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Charles Douglas Edmondson by the Centers for Medicare & Medicaid Services?
The Charles Douglas Edmondson has been assigned the NPI (National Provider Identifier) 1669589040 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please provide the complete street address where Charles Douglas Edmondson is physically located?
The Charles Douglas Edmondson is physically situated at the following address: 611 Thompson Ave, El Dorado, AR, 717304557.
What is Charles Douglas Edmondson's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Charles Douglas Edmondson's specialized field of practice is Specialist, and the corresponding taxonomy code that categorizes this area of specialization is 174400000X.
On what date did Charles Douglas Edmondson receive its 1669589040 assignment from the Centers for Medicare & Medicaid Services?
The Charles Douglas Edmondson was assigned its 1669589040 on 2006-08-23, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information regarding Charles Douglas Edmondson, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Charles Douglas Edmondson, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2007-10-15.