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General NPI Number Information
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NPI Number | 1053317156
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Entity Type | Individual
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Provider Name | JAMES EARL REDFIELD JR. MD
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 09/12/2023
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Provider Practice Location Address
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Address Line | 1023 N MOUND ST STE H
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4453
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Country | US
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Telephone | 936-569-2590
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Fax | 936-569-2592
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Provider Business Mailing Address
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Address Line | 1204 N MOUND ST
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City | NACOGDOCHES
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State | TX
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Zip | 75961-4027
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Country | US
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Telephone | 936-568-8424
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | H2713
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License Number State | TX
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