Provider Demographics
NPI:1841301280
Name:REDMOND, JOHN W (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:REDMOND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:85 BARNES RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492
Mailing Address - Country:US
Mailing Address - Phone:203-284-9448
Mailing Address - Fax:203-269-1361
Practice Address - Street 1:85 BARNES RD
Practice Address - Street 2:SUITE 102
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492
Practice Address - Country:US
Practice Address - Phone:203-284-9448
Practice Address - Fax:203-269-1361
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT17873207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT2V3747OtherHEALTHNET
CT733663OtherCONNECTICARE
CTP369472OtherOXFORD
CT010017873CT02OtherANTHEM BC/BS
CT2V3747OtherHEALTHNET
B37599Medicare UPIN