MEDICARE: ROBERT N. REDDIX JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	L7133	TX
2	207X00000X	Orthopaedic Surgery Physician	2006-00209	NC
3	207X00000X	Orthopaedic Surgery Physician	L7133	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	P01447545	OTHER	TX	RAILROAD MEDICARE
7	P01666362	OTHER	TX	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8U1283	OTHER	TX	BCBS
3	1U8019	OTHER	TX	PTAN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265494611
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT N. REDDIX JR. MD

Provider Business Mailing Address
First Line	:	367 S GULPH RD, ATN :IPM CREDENTIALING
Second Line	:	ATN :IPM CREDENTIALING
City	:	KING OF PRUSSIA
State	:	PA
Zip	:	19406-3121
Country	:	US
Telephone Number	:	806-398-3627
Fax Number	:	806-351-7801

Provider Business Practice Location Address
First Line	:	3501 S SONCY RD STE 104
Second Line	:
City	:	AMARILLO
State	:	TX
Zip	:	79119-6405
Country	:	US
Telephone Number	:	806-398-3627
Fax Number	:	806-351-7801

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	10/15/2021

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Directions to “ ROBERT N. REDDIX JR. MD” Practice Location

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