Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 19387 | OK |
Y | 207QA0401X | Family Doctor - Addiction Medicine | 19387 | OK |
NPI | 1750537882 |
---|---|
Provider Name | Dr. Todd Scott Redding |
First Address | Tulsa, OK 74105-1750 |
Second Address | Tulsa, OK 74105-1750 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2008 |
Last Update Date | 20/08/2021 |