Healthcare Provider Details

I. General information

NPI: 1770572166
Provider Name (Legal Business Name): REDMOND PHYSICIANS PRACTICE CO. II
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5470 MARTHA BERRY HWY
ARMUCHEE GA
30105-2302
US

IV. Provider business mailing address

5470 MARTHA BERRY HWY
ARMUCHEE GA
30105-2302
US

V. Phone/Fax

Practice location:
  • Phone: 706-235-1156
  • Fax: 706-291-9391
Mailing address:
  • Phone: 706-235-1156
  • Fax: 706-291-9391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. PATRICK BIRMINGHAM
Title or Position: DIRECTOR
Credential:
Phone: 615-373-7625