Individual
REGGIE EUGENE MAGGARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65201-5276
(573) 882-2568
(573) 882-2226
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
2004004466
MO
367500000X
Certified Registered Nurse Anesthetist
Primary
2004004466
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1972740082
—
MO
Enumeration date
01/12/2009
Last updated
12/01/2022
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