Angelena B Edwards, MD | |
3999 Dutchmans Ln Ste 6f, Louisville, KY 40207-4724 | |
(502) 559-1670 | |
(502) 349-1999 |
Full Name | Angelena B Edwards |
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Gender | Female |
Speciality | Urology - Pediatric Urology |
Location | 3999 Dutchmans Ln Ste 6f, Louisville, Kentucky |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073856860 | NPI | - | NPPES |
1073856860 | Medicaid | KY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208800000X | Urology | MD-47279 (Iowa) | Secondary |
2088P0231X | Urology - Pediatric Urology | MD-47279 (Iowa) | Secondary |
2088P0231X | Urology - Pediatric Urology | 59770 (Kentucky) | Primary |
Entity Name | State University Of Iowa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1477554814 PECOS PAC ID: 7618884230 Enrollment ID: O20031107000060 |
Mailing Address | Practice Location Address |
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Angelena B Edwards, MD Po Box 776879, Chicago, IL 60677-6879 Ph: (502) 588-9490 | Angelena B Edwards, MD 3999 Dutchmans Ln Ste 6f, Louisville, KY 40207-4724 Ph: (502) 559-1670 |
Mr. Mohammed Adnan Said, MD Urology Medicare: Accepting Medicare Assignments Practice Location: 401 E Chestnut St Unit 520, Louisville, KY 40202 Phone: 502-588-4740 Fax: 502-588-9537 | |
Dr. Mohammad Amin, MD Urology Medicare: Medicare Enrolled Practice Location: 800 Zorn Ave, Veterans Affairs Medical Center, Louisville, KY 40206 Phone: 502-287-4000 Fax: 502-287-6825 | |
Dr. Kellen Bo Yung Choi, D.O. Urology Medicare: Accepting Medicare Assignments Practice Location: 401 E Chestnut St Unit 480, Louisville, KY 40202 Phone: 502-588-4740 Fax: 502-588-9537 | |
Ross Micciche, Urology Medicare: Medicare Enrolled Practice Location: 501 E Broadway Ste 270, Louisville, KY 40202 Phone: 502-588-4740 | |
Anthony J. Casale, M.D. Urology Medicare: Medicare Enrolled Practice Location: 234 E Gray St, Suite 662, Louisville, KY 40202 Phone: 502-629-4220 | |
Rosa Park, M.D. Urology Medicare: Not Enrolled in Medicare Practice Location: 401 E Chestnut St Unit 510, Louisville, KY 40202 Phone: 502-588-4740 |