| Doctor Name: | JAMIE RYAN EDWARDS |
| NPI Number: | 1982832572 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DO |
| License Number: | 67212 |
| Business Practice Address: | 1120 15th St Augusta, GA - 309120004 |
| Business Phone Number: | 7067212423 |
| Business Fax Number: | |
| Mailing Address: | 62 Scenic Lakes Dr, NORTH AUGUSTA |
| State: | SC |
| Postal Code: | 298418631 |
| Phone Number: | 9125962785 |
| Fax Number: | |
| NPI Enumeration Date: | 06/23/2009 |
| NPI Last Update Date: | 04/15/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 67212 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |