Individual
JEFF S REDMOND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2939
(985) 280-8545
Mailing address
206 DELTA DR, MANDEVILLE, LA 70448-7562
(985) 237-8787
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0000041854
TN
2085R0202X
Diagnostic Radiology Physician
Primary
MD.202882
LA
2085R0202X
Diagnostic Radiology Physician
ME101200
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01002054
—
MS
05
—
1057924
—
LA
01
—
AK548X
MEDICARE PIN
—
01
—
AK548Z
MEDICARE PIN
—
Enumeration date
07/12/2007
Last updated
02/14/2018
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