Robert Edward Edge, O.D. Valid NPI

Individual provider · Optometrist · Jackson, AL

NPI

1659374361

Type

Individual (Type 1)

Primary specialty

Optometrist

Specialty group

Eye and Vision Services Providers

Taxonomy code

152W00000X

License number

S412TA033 (AL)

Sex

Male

Sole proprietor

No

Enumerated

2005-05-27

Last updated

2007-11-19