1114174604 NPI number — NATALIE TAYLOR REDDINGTON D.O.

Table of content: NATALIE TAYLOR REDDINGTON D.O. (NPI 1114174604)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114174604 NPI number — NATALIE TAYLOR REDDINGTON D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
REDDINGTON
Provider First Name:
NATALIE
Provider Middle Name:
TAYLOR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114174604
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3686 GRANDVIEW PARKWAY
Provider Second Line Business Mailing Address:
SUITE 320
Provider Business Mailing Address City Name:
BIRMINGHAM
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35243
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-971-5499
Provider Business Mailing Address Fax Number:
205-971-5438

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3686 GRANDVIEW PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 320
Provider Business Practice Location Address City Name:
BIRMINGHAM
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35243
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-971-5499
Provider Business Practice Location Address Fax Number:
205-971-5438
Provider Enumeration Date:
08/26/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  DO.1030 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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