DR. JOHN CHARLES EDLIN M.D. NPI 1114936614

NPI Information

NPI: 1114936614
Provider Name: DR. JOHN CHARLES EDLIN, M.D.
Classification: Family Medicine - 207QA0000X
Entity Type: Individual

Specialization: Adolescent Medicine

Address:
12800 HILLCREST RD
SUITE 216
DALLAS, TX
ZIP 75230
Phone: (972) 239-9252
Get Directions

DR. John Charles Edlin, M.D. is an adolescent medicine family medicine in Dallas, TX. The provider is a family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. DR. John Charles Edlin, M.D. NPI is 1114936614. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

12800 HILLCREST RD
SUITE 216
DALLAS, TX
ZIP 75230-524
Phone: (972) 239-9252
Fax: (972) 404-9609

The enumeration date for this NPI number is 8/5/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207QA0000X	Family Medicine	Adolescent Medicine	E1307	TEXAS	Yes
2	2080A0000X	Pediatrics	Adolescent Medicine	E1307	TEXAS	X
3	101YM0800X	Counselor	Mental Health			X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	E80368	MEDICARE UPIN	TEXAS
2	886542	OTHER	TEXAS	BLUE CROSS BLUE SHIELD

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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