| Kevin P Reagan Mdpc | |
|
11704 W Center Rd Ste 210 Omaha NE 68144-4327 | |
| (402) 334-3377 | |
| (402) 691-9922 |
| Full Name | Kevin P Reagan Mdpc |
|---|---|
| Speciality | Internal Medicine |
| Location | 11704 W Center Rd Ste 210, Omaha, Nebraska |
| Authorized Official Name and Position | Mary Derouchey (PRACTICE MANAGER) |
| Authorized Official Contact | 4023300444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin P Reagan Mdpc 11704 W Center Rd Ste 210 Omaha NE 68144-4327 Ph: (402) 334-3377 | Kevin P Reagan Mdpc 11704 W Center Rd Ste 210 Omaha NE 68144-4327 Ph: (402) 334-3377 |
| NPI Number | 1679768899 |
|---|---|
| Provider Enumeration Date | 09/11/2007 |
| Last Update Date | 08/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679768899 | NPI | - | NPPES |
| 1020800 | Medicaid | IA | |
| 110219831 | Other | NE | TRAVELERS RR MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 16148 (Nebraska) | Primary |
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