# REDMOND PHYSICIAN PRACTICE COMPANY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Redmond Family Care Center at East Rome
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023007424
- **Authorized official:** MR. CHUCK LOCKE (VP)
- **Authorized official phone:** (615) 373-7604

## Contact information

- **Practice address:** 715 E 2ND AVE SW, ROME, GA 30161-6148
- **Practice address phone:** (706) 235-1102
- **Practice address fax:** (706) 235-7188
- **Mailing address:** 715 E 2ND AVE SW, ROME, GA 30161-6148
- **Mailing address phone:** (706) 235-1102
- **Mailing address fax:** (706) 235-7188

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/18/2005
- **Last updated:** 12/10/2007