Healthcare Provider Details

I. General information

NPI: 1710045521
Provider Name (Legal Business Name): BATH COUNTY FAMILY PRACTICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/05/2006
Last Update Date: 11/20/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

106 PARK DRIVE SUITE A
HOT SPRINGS VA
24445-0797
US

IV. Provider business mailing address

PO BOX 797 106 PARK DRIVE
HOT SPRINGS VA
24445-0797
US

V. Phone/Fax

Practice location:
  • Phone: 540-839-5287
  • Fax: 540-839-4831
Mailing address:
  • Phone: 540-839-5287
  • Fax: 540-839-4831

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0101039753
License Number StateVA

VIII. Authorized Official

Name: DR. JAMES F REDINGTON
Title or Position: OWNER
Credential: M.D.
Phone: 540-839-5287