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Individual

JOSEPH W REDCROSS II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
55 WHITCHER ST NE STE 130, MARIETTA, GA 30060-1156
(770) 428-0462
(770) 427-8001
Mailing address
55 WHITCHER ST NE STE 130, MARIETTA, GA 30060-1156
(770) 428-0462

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
1132
SC
208600000X
Surgery Physician
1132
SC
208600000X
Surgery Physician
Primary
69941
GA
208600000X
Surgery Physician
OT 010413
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3518
SC
Enumeration date
07/20/2007
Last updated
11/08/2019
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