Healthcare Provider Details

I. General information

NPI: 1134336068
Provider Name (Legal Business Name): DR. ALAN REDDING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2007
Last Update Date: 08/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 HOWELL MILL RD NW SUITE 102
ATLANTA GA
30327-2100
US

IV. Provider business mailing address

3193 HOWELL MILL RD NW SUITE 102
ATLANTA GA
30327-2100
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-0078
  • Fax: 404-355-0079
Mailing address:
  • Phone: 404-355-0078
  • Fax: 404-355-0079

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number61327
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number61327
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: