Jonathan R Redwing is a Surgical in Tyler, Texas. Jonathan R Redwing practices all healthcare services and medical treatments related to Surgical. The NPI Number for Jonathan R Redwing is 1649309410. The last update date is 2022-10-23.
Jonathan R Redwing's current location address is 3414 Golden Rd, Tyler, Texas. You can contact this provider via phone number 9039397500 and fax number 9039397728. The mailing address for Jonathan R Redwing is 3414 Golden Rd, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jonathan R Redwing |
|---|---|
| Address | 3414 Golden Rd, Tyler, Texas |
| Phone Number | 9039397500 |
| Fax Number | 9039397728 |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1649309410 |
|---|---|
| Provider Enumeration Date | 2007-03-05 |
| Last Updated Date | 2022-10-23 |
Provider Mailing Address Detail
| Address | 3414 Golden Rd |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757018336 |
| Phone Number | 9039397500 |
| Fax Number | 9039397728 |
Provider's Primary Taxonomy Detail
| Speciality | Surgical |
|---|---|
| Taxonomy | 363As0400X |
| Licence No | PA20070012 |
|
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 10034669 | NM | CIGNA/LOVELACE | |
| P00465646 | NM | RAILROAD MCEDICARE | |
| 80203361 | NM | -- | |
| 00NM00RL61 | NM | BCBS |
Post Comment/ Review Below
What is the unique 10-digit identifier code issued to Jonathan R Redwing by the Centers for Medicare & Medicaid Services?
The Jonathan R Redwing has been assigned the NPI (National Provider Identifier) 1649309410 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you share the physical location details of Jonathan R Redwing?
The Jonathan R Redwing is situated at 3414 Golden Rd, in the city of Tyler, state of TX, with the zip code 757018336.
What is the Jonathan R Redwing's specialty and taxonomy code?
The Jonathan R Redwing's specialty is Surgical, and the corresponding taxonomy code is 363As0400X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1649309410 to Jonathan R Redwing?
The Centers for Medicare & Medicaid Services originally issued the 1649309410 to Jonathan R Redwing on 2007-03-05.
When was the information regarding Jonathan R Redwing most recently updated?
The details pertaining to the Jonathan R Redwing, including its address, specialty, and other relevant information, were last refreshed on 2022-10-23.