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General NPI Number Information
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NPI Number | 1215978739
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Entity Type | Individual
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Provider Name | JOHN FULTON REDDING II MD
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 5921 W FRIENDLY AVE STE D
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City | GREENSBORO
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State | NC
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Zip | 27410-3268
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Country | US
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Telephone | 336-551-5830
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Fax | 336-268-3160
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Provider Business Mailing Address
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Address Line | 2415 PHILADELPHIA LAKE CT
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City | GREENSBORO
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State | NC
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Zip | 27408-4300
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Country | US
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Telephone | 336-302-2082
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 9501388
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License Number State | NC
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