Individual
DR. RONALD S REAGIN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
656 A-B S MAIN ST, BAXLEY, GA 31515
(912) 367-5281
(912) 367-5240
Mailing address
PO BOX 708, 656 A-B S MAIN ST, BAXLEY, GA 31515-0708
(912) 367-5281
(912) 367-5240
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
000613
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000415346A
—
GA
01
—
480007952
RAILROAD MEDICARE
GA
01
—
48SCBCS
MEDICARE ID TYPE PODIATRY
GA
Enumeration date
12/13/2005
Last updated
10/16/2007
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