Provider Demographics
NPI:1548426604
Name:REDDINGTON, MARK (DO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:REDDINGTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11560 CHAPMAN HWY
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SEYMOUR
Mailing Address - State:TN
Mailing Address - Zip Code:37865-5044
Mailing Address - Country:US
Mailing Address - Phone:865-577-1914
Mailing Address - Fax:865-577-1714
Practice Address - Street 1:11560 CHAPMAN HWY
Practice Address - Street 2:SUITE 1
Practice Address - City:SEYMOUR
Practice Address - State:TN
Practice Address - Zip Code:37865-5044
Practice Address - Country:US
Practice Address - Phone:865-577-1914
Practice Address - Fax:865-577-1714
Is Sole Proprietor?:No
Enumeration Date:2008-07-29
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN2258207P00000X, 2081S0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine