Mr. Edgar T. Victoria MD
Surgery Physician in Gadsden, AL(View on Map)
Full Name
Mr. Edgar Tating Victoria MD
NPI Number
1023122421
NPI Type
Individual Provider
Gender
Male
Enumeration Date
08/19/2006
Specialties
(Taxonomies)Code
208600000X
204C00000X
Primary Taxonomy
Yes
No
Licenses
State
Alabama
Alabama
License Number
7957
00007957
Contact
Information
Purpose
Mailing
Location
Address
P.O. BOX 97
1411 PIEDMONT CUTOFF
City
Gadsden
Gadsden
State
AL
AL
Postal Code
35902
35903
Country
US
US
Telephone Number
(256) 492-0131
(256) 492-0131
Identifiers
Identifier
143995 (COMPLEX)
51046490
51094372
630736845
143752 (WADLEY)
143836 (CLEBURNE)
143754 (ANNISTON)
100906
000046490
Unknown
Identifier State
AL
AL
AL
AL
AL
AL
AL
AL
AL
Unknown
Identifier Issuer
Unknown
BLUE CROSS
BLUECROSS
IRS TAXPER IDENTIFICATION
Unknown
Unknown
Unknown
Unknown
Unknown
Unknown
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 03/25/2013