Provider Information for 1154500460
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Mr. BILLY RAY EDWARDS Jr. M.Ed.
Sex: Male
NPI: 1154500460
Last Updated: 2007-11-02
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1154500460 | ||||||||
| Enumeration Date | 2007-11-02 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | PO BOX 720221 NORMAN, OK 73070-4168 United States Phone: 405-819-7467 | Fax: | ||||||||
| Primary Practice Address | 5131 N CLASSEN BLVD OKLAHOMA CITY, OK 73118-5258 United States Phone: 405-767-1126 | Fax:405-767-6285 | ||||||||
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