Individual
KEVIN J O'REGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1 MEDICAL DR, LEBANON, NH 03756-1000
(603) 650-5724
Mailing address
1 MEDICAL DR, LEBANON, NH 03756-1000
(603) 650-5724
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1701
NH
363AM0700X
Medical Physician Assistant
OA002746
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23-2359401
MLHC TAX ID #
PA
01
—
440771
MLHC MEDICARE AA #
PA
Enumeration date
10/21/2006
Last updated
04/02/2021
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