Healthcare Provider Details

I. General information

NPI: 1487251559
Provider Name (Legal Business Name): REAGAN KATHLEEN HAUPT DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REAGAN KATHLEEN KAISER DPT

II. Dates (important events)

Enumeration Date: 10/02/2020
Last Update Date: 11/29/2023
Certification Date: 11/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 GADSDEN HWY
BIRMINGHAM AL
35235-3134
US

IV. Provider business mailing address

1801 GADSDEN HWY
BIRMINGHAM AL
35235-3134
US

V. Phone/Fax

Practice location:
  • Phone: 205-228-7600
  • Fax:
Mailing address:
  • Phone: 205-228-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License NumberPTH10009
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH10009
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: