Healthcare Provider Details

I. General information

NPI: 1528050481
Provider Name (Legal Business Name): KEVIN P REDMOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 04/05/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

IV. Provider business mailing address

234 GOODMAN ST
CINCINNATI OH
45219-2364
US

V. Phone/Fax

Practice location:
  • Phone: 513-584-3494
  • Fax: 513-584-4007
Mailing address:
  • Phone: 513-584-3494
  • Fax: 513-584-4007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number35-04-9201
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: