Provider Demographics
NPI:1801822317
Name:REDMANN, GREGORY ALPHONSE (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:ALPHONSE
Last Name:REDMANN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1430 TULANE AVE
Mailing Address - Street 2:# 8065
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2632
Mailing Address - Country:US
Mailing Address - Phone:504-988-9190
Mailing Address - Fax:504-988-9191
Practice Address - Street 1:1415 TULANE AVE
Practice Address - Street 2:HC82
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2600
Practice Address - Country:US
Practice Address - Phone:504-988-5231
Practice Address - Fax:504-988-1727
Is Sole Proprietor?:No
Enumeration Date:2006-06-25
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA09334R2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1934305Medicaid
E12646Medicare UPIN
LA4N509Medicare PIN