Gerald G. Edds, PSC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

300176 Issued in KY

Legal business name

GERALD G. EDDS, PSC

Doing business as

Southpark Surgicare

Practice address

2835 Farrell Cres
Owensboro, KY 42303-1393

Phone

(270) 926-9033

Fax

(270) 926-4896

NPI assigned

Jun 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gerald Glynn Edds, MD

Title

Owner

Phone

(270) 926-9033

Specialties & licenses 1

Addresses

Other names 1

• Southpark Surgicare Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291075200000",
    "number": "1154359735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2835 FARRELL CRES",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031393",
            "telephone_number": "270-926-9033",
            "fax_number": "270-926-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2835 FARRELL CRES",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423031393",
            "telephone_number": "270-926-9033",
            "fax_number": "270-926-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD G. EDDS, PSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-11-30",
        "status": "A",
        "authorized_official_last_name": "EDDS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "GLYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-926-9033",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "KY",
            "license": "300176",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southpark Surgicare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Ambulatory Surgical Clinic/Center in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Ambulatory Surgical Clinic/Center in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.