Basic Information
| Provider Information | |||||||||
| NPI: | 1033106976 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | PRESTON | ||||||||
| MiddleName: | HILL | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1337 | ||||||||
| Address2: | |||||||||
| City: | GALAX | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243331337 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2762363210 | ||||||||
| FaxNumber: | 2762368780 | ||||||||
| Practice Location | |||||||||
| Address1: | 702 PINE ST | ||||||||
| Address2: | |||||||||
| City: | HILLSVILLE | ||||||||
| State: | VA | ||||||||
| PostalCode: | 243431405 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2767284311 | ||||||||
| FaxNumber: | 2767280901 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/05/2005 | ||||||||
| LastUpdateDate: | 03/29/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 0101026339 | VA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 010108250 | 05 | VA | MEDICAID |