B.O. Edwards, M.D., LLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

028160 Issued in GA

Legal business name

B.O. EDWARDS, M.D., LLC

Practice address

1030 Woodlands Rd
Box 110
Watkinsville, GA 30677-1990

Phone

(706) 769-7911

Fax

(706) 769-0826

NPI assigned

Jul 13, 2007

Organization subpart

No

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

Authorized official

Name

Buford Otto Edwards Jr., M.D.

Title

President/Owner

Phone

(706) 769-7911

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184284800000",
    "number": "1689873176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 WOODLANDS RD",
            "address_2": "PO BOX 110",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306771990",
            "telephone_number": "706-769-7911",
            "fax_number": "706-769-0826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 WOODLANDS RD",
            "address_2": "BOX 110",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306771990",
            "telephone_number": "706-769-7911",
            "fax_number": "706-769-0826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "B.O. EDWARDS, M.D., LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2007-07-13",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "BUFORD",
        "authorized_official_middle_name": "OTTO",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "706-769-7911",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "028160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2007; 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.