1528271152 NPI number — ERIC M EDDS MD

Table of content: ERIC M EDDS MD (NPI 1528271152)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528271152 NPI number — ERIC M EDDS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EDDS
Provider First Name:
ERIC
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1528271152
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
THE MEDICAL CENTER @ FRANKLIN
Provider Second Line Business Mailing Address:
1100 BROOKHAVEN ROAD
Provider Business Mailing Address City Name:
FRANKLIN
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
42134-2746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
270-598-4800
Provider Business Mailing Address Fax Number:
931-552-6663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
THE MEDICAL CENTER @ FRANKLIN
Provider Second Line Business Practice Location Address:
1100 BROOKHAVEN ROAD
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
42134-2746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
270-598-4800
Provider Business Practice Location Address Fax Number:
931-552-6663
Provider Enumeration Date:
05/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2085R0202X , with the licence number:  01060222A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 2012020204 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085U0001X , with the licence number: 01060222A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X , with the licence number: 42084 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 000000532350 . This is a "ANTHEM BCBS" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: 7100263600 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200870120 , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 24598 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00452678 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P00742709 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( IN ) . This identifiers is of the category "OTHER".
  • Identifier: P01199200 . This is a "KY RR MEDICARE" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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