Individual
MR. REAGAN BENNETT LEACH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1200 BRECKENRIDGE ST, OWENSBORO, KY 42303-1089
(270) 685-8228
(270) 926-2069
Mailing address
1200 BRECKENRIDGE ST, OWENSBORO, KY 42303-1089
(270) 685-8228
(270) 926-2069
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831724905
—
KY
Enumeration date
03/09/2020
Last updated
08/23/2024
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