Provider Demographics
NPI:1053940981
Name:REGAN, RACHEL (MD)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:REGAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RACHEL
Other - Middle Name:
Other - Last Name:GEENEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:160 S TUTTLE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1553
Mailing Address - Country:US
Mailing Address - Phone:937-523-9690
Mailing Address - Fax:937-523-9698
Practice Address - Street 1:247 S BURNETT RD
Practice Address - Street 2:SUITE 210
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505
Practice Address - Country:US
Practice Address - Phone:937-328-8850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-03
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.148633207Q00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program