Healthcare Provider Details

I. General information

NPI: 1154491538
Provider Name (Legal Business Name): JAMES FRANKLIN REDINGTON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 JACKSON RIVER RD
MONTEREY VA
24465-2614
US

IV. Provider business mailing address

PO BOX 490
MONTEREY VA
24465-0490
US

V. Phone/Fax

Practice location:
  • Phone: 540-468-6400
  • Fax: 540-468-3301
Mailing address:
  • Phone: 540-468-6400
  • Fax: 540-468-3301

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number39753
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: