person
Jonathan R Redwing, PA-C
Surgical Physician Assistant in Tyler, Texas
NPI 1649309410

Jonathan R Redwing is a Surgical Physician Assistant based in Tyler, TX and is specialized in Surgical. Jonathan R Redwing practices in Tyler, TX and has the professional credentials of PA-C. The NPI Number for Jonathan R Redwing is 1649309410 and holds a License No. PA20070012 (Texas).

The current practice location address for Jonathan R Redwing is 3414 Golden Rd, Tyler, TX and can be reached out via phone at 903-939-7500 and via fax at 903-939-7728.

Location: 3414 Golden Rd, Tyler, TX, 75701-8336
person
Provider Profile Details
NPI Number
1649309410
Provider Name
Jonathan R Redwing
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
3414 Golden Rd, Tyler, TX, 75701-8336
Phone Number
903-939-7500
Fax Number
903-939-7728
Provider Enumeration Date
03/05/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
10034669 01 NM CIGNA/LOVELACE
P00465646 01 NM RAILROAD MCEDICARE
80203361 05 NM
00NM00RL61 01 NM BCBS
institution
Provider Business Practice Location Address Details
Address
3414 Golden Rd
City
State
Zip
75701-8336
Phone Number
903-939-7500
Fax Number
903-939-7728
person
Provider Business Mailing Address Details
Address
3414 Golden Rd
City
State
Zip
75701-8336
Phone Number
903-939-7500
Fax Number
903-939-7728
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA20070012 (New Mexico)
Definition
Definition to come...
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