Provider Demographics
NPI:1154345130
Name:EDWARDS, THOMAS H III (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:H
Last Name:EDWARDS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 12366
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35202-2366
Mailing Address - Country:US
Mailing Address - Phone:205-780-7101
Mailing Address - Fax:205-206-8338
Practice Address - Street 1:833 PRINCETON AVE SW
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211-1323
Practice Address - Country:US
Practice Address - Phone:205-206-8480
Practice Address - Fax:205-206-8300
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL06609208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALC76646Medicare UPIN
AL510-06969Medicare ID - Type Unspecified