Provider Demographics
NPI:1487736021
Name:REDMAN, MICHAEL K (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:K
Last Name:REDMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7276 BURLINGTON PIKE
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1550
Mailing Address - Country:US
Mailing Address - Phone:859-282-8006
Mailing Address - Fax:859-282-0149
Practice Address - Street 1:7276 BURLINGTON PIKE
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1550
Practice Address - Country:US
Practice Address - Phone:859-282-8006
Practice Address - Fax:859-282-0149
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4354111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000051825OtherANTHEM BC/BS
KY85002681Medicaid
KY85002681Medicaid
KY350050373Medicare ID - Type UnspecifiedRAILROAD MEDICARE