Healthcare Provider Details

I. General information

NPI: 1871567263
Provider Name (Legal Business Name): RITA M EGAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/14/2006
Last Update Date: 03/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3260 LEXINGTON RD
NICHOLASVILLE KY
40356-9798
US

IV. Provider business mailing address

3260 LEXINGTON RD
NICHOLASVILLE KY
40356-9798
US

V. Phone/Fax

Practice location:
  • Phone: 720-771-4015
  • Fax:
Mailing address:
  • Phone: 720-771-4015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number24896
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: