MEDICARE: ANNE REDDINGTON DO LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician
2	208M00000X	Hospitalist Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588055636
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANNE REDDINGTON DO LLC

Provider Business Mailing Address
First Line	:	PO BOX 638786
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45263-8786
Country	:	US
Telephone Number	:	937-949-4567
Fax Number	:	937-350-6477

Provider Business Practice Location Address
First Line	:	707 S EDWIN C MOSES BLVD
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45417-3462
Country	:	US
Telephone Number	:	937-949-4567
Fax Number	:	937-350-6477

Authorized Official
Title or Position	:	OWNER
Name	:	ANNE K REDDINGTON
Credential	:	DO
Telephone Number	:	937-949-4567

Provider Enumeration Date	:	02/11/2015
Last Update Date	:	05/24/2019

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