Redwing, Jonathan R

Redwing, Jonathan R is an individual health care provider with primary practice located at 3414 Golden Rd , Tyler TX 75701-8336. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Redwing, Jonathan R can be contacted via phone (903) 939-7500.

Contact Information

Primary practice address
3414 Golden Rd Tyler TX 75701-8336
Phone: (903) 939-7500
Fax: (903) 939-7728
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA20070012 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA07915 Texas

Profile Details

NPI number 1649309410
LBN Legal business name Redwing, Jonathan R
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2007
Last updated Oct 23rd, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649309410 NPPES
New Mexico Other 10034669 CIGNA/LOVELACE
New Mexico Other P00465646 CIGNA/LOVELACE
New Mexico MEDICAID 80203361 CIGNA/LOVELACE
New Mexico Other 00NM00RL61 CIGNA/LOVELACE

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