Individual
REGINALD FEARS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1947 N FOUNDERS CIR, WICHITA, KS 67206-3548
(316) 613-4670
Mailing address
PO BOX 8035, WICHITA, KS 67208-0035
(316) 689-9135
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
01088276A
IN
208100000X
Physical Medicine & Rehabilitation Physician
036.167047
IL
208100000X
Physical Medicine & Rehabilitation Physician
04-38273
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003719396
MEDICARE
—
05
—
201116030A
—
KS
Enumeration date
07/01/2011
Last updated
11/16/2023
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