Healthcare Provider Details

I. General information

NPI: 1801822317
Provider Name (Legal Business Name): GREGORY ALPHONSE REDMANN MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 09/01/2020
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 TULANE AVE HC82
NEW ORLEANS LA
70112-2600
US

IV. Provider business mailing address

1430 TULANE AVE # 8065
NEW ORLEANS LA
70112-2632
US

V. Phone/Fax

Practice location:
  • Phone: 504-988-5231
  • Fax: 504-988-1727
Mailing address:
  • Phone: 504-988-9190
  • Fax: 504-988-9191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number09334R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: