Healthcare Provider Details

I. General information

NPI: 1669038956
Provider Name (Legal Business Name): KATHERINE D REDMOND DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2019
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 COMMONWEALTH RD
VANCEBURG KY
41179-5003
US

IV. Provider business mailing address

1735 27TH ST STE B06
PORTSMOUTH OH
45662-2681
US

V. Phone/Fax

Practice location:
  • Phone: 606-796-0010
  • Fax: 606-796-0011
Mailing address:
  • Phone: 740-356-8681
  • Fax: 740-356-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number34.016685
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number34.016685
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code2080S0010X
TaxonomyPediatric Sports Medicine Physician
License Number05605
License Number StateKY
# 4
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number05605
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: