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Individual

JONATHAN ROBERT REDDING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1220 JEFFERSON ST, LAUREL, MS 39440-4355
(601) 425-7550
Mailing address
PO BOX 247, LAUREL, MS 39441-0247
(601) 425-7550

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
30040
MS
390200000X
Student in an Organized Health Care Education/Training Program
NC

Other

Enumeration date
04/01/2019
Last updated
08/08/2022
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