Provider Demographics
NPI:1689857518
Name:REDINGTON, THOMAS JOHN JR (MD MBA FACP)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOHN
Last Name:REDINGTON
Suffix:JR
Gender:M
Credentials:MD MBA FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 CLOUGH PIKE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45244-4053
Mailing Address - Country:US
Mailing Address - Phone:513-564-1640
Mailing Address - Fax:513-564-1637
Practice Address - Street 1:6620 CLOUGH PIKE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45244-4053
Practice Address - Country:US
Practice Address - Phone:513-564-1640
Practice Address - Fax:513-564-1637
Is Sole Proprietor?:No
Enumeration Date:2007-12-13
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.059291207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0812277Medicaid
OHRE0674297Medicare PIN
KY64864564Medicaid