Provider Demographics
NPI:1508695990
Name:REDMAN, THOMAS MCCLELLAN IV
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:MCCLELLAN
Last Name:REDMAN
Suffix:IV
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 N MARKET ST APT A
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-1162
Mailing Address - Country:US
Mailing Address - Phone:740-275-1430
Mailing Address - Fax:
Practice Address - Street 1:314 N MARKET ST APT A
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-1162
Practice Address - Country:US
Practice Address - Phone:740-275-1430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-01
Last Update Date:2024-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator