Provider Demographics
NPI:1154852879
Name:REDFORD, ALBERT IV (DO)
Entity Type:Individual
Prefix:
First Name:ALBERT
Middle Name:
Last Name:REDFORD
Suffix:IV
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85724-0001
Mailing Address - Country:US
Mailing Address - Phone:520-626-4111
Mailing Address - Fax:520-626-5018
Practice Address - Street 1:2380 N FERGUSON AVE STE 100
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2837
Practice Address - Country:US
Practice Address - Phone:520-324-4850
Practice Address - Fax:522-032-4142
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM390200000X
AZR3370390200000X
AZ009613207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program