Individual
RICHARD STEPHEN REAGIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
104 CHURCH ST, DECATUR, GA 30030-3325
(404) 378-3694
(404) 373-0741
Mailing address
104 CHURCH ST, DECATUR, GA 30030-3325
(404) 378-3694
(404) 373-0741
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1149T
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000368002B
—
GA
Enumeration date
10/17/2006
Last updated
07/13/2015
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