Provider Demographics
NPI:1306105804
Name:EDON, ADELEYE A (DO)
Entity type:Individual
Prefix:
First Name:ADELEYE
Middle Name:A
Last Name:EDON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ADELEYE
Other - Middle Name:ANNICK MURIEL
Other - Last Name:EDON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:740-845-7700
Mailing Address - Fax:740-845-7701
Practice Address - Street 1:210 N MAIN ST
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1115
Practice Address - Country:US
Practice Address - Phone:740-845-7700
Practice Address - Fax:740-845-7701
Is Sole Proprietor?:No
Enumeration Date:2012-05-04
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYR2915207R00000X
OH34.012823207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine