Healthcare Provider Details

I. General information

NPI: 1720057417
Provider Name (Legal Business Name): REGINALD PATRICK SEGAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/15/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 WEST MAPLE AVENUE
EUNICE LA
70535
US

IV. Provider business mailing address

PO BOX 967
EUNICE LA
70535
US

V. Phone/Fax

Practice location:
  • Phone: 337-546-0424
  • Fax: 337-457-7989
Mailing address:
  • Phone: 337-546-0424
  • Fax: 337-457-7989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number011877
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: