Provider Demographics
NPI:1053317156
Name:REDFIELD, JAMES EARL JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:EARL
Last Name:REDFIELD
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1204 N MOUND ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-4027
Mailing Address - Country:US
Mailing Address - Phone:936-568-8424
Mailing Address - Fax:
Practice Address - Street 1:1023 N MOUND ST STE H
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-4453
Practice Address - Country:US
Practice Address - Phone:936-569-2590
Practice Address - Fax:936-569-2592
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2023-09-12
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
TXH2713208600000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX098880001Medicaid
TX00J22FOtherBCBS
020018012OtherRAILROAD MEDICARE
TX752429273OtherAETNA
TX00J22FOtherBCBS
TXF28755Medicare UPIN