MEDICARE: JEFFREY MAURICE REAGAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	49407	AZ

General Provider Information

NPI Number	:	1477750636
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY MAURICE REAGAN M.D.

Provider Business Mailing Address
First Line	:	4830 HIGHWAY 260 STE 103
Second Line	:
City	:	LAKESIDE
State	:	AZ
Zip	:	85929-5851
Country	:	US
Telephone Number	:	928-537-8777
Fax Number	:	928-537-1914

Provider Business Practice Location Address
First Line	:	4830 HIGHWAY 260 STE 103
Second Line	:
City	:	LAKESIDE
State	:	AZ
Zip	:	85929-5851
Country	:	US
Telephone Number	:	928-537-8777
Fax Number	:	928-537-1914

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	07/15/2014

Similar Medicare Providers

1033109632 — DR. JACOB BLAINE OLDHAM
Practice Location Address:

4830 HIGHWAY 260 STE 103
LAKESIDE, AZ
85929-5851

Practice Phone: 928-537-8777
Practice Fax: 928-537-1914

1952352619 — HUGH RYAN HALL DPM
Practice Location Address:

4830 HIGHWAY 260 STE 103
LAKESIDE, AZ
85929-5851

Practice Phone: 928-532-5227
Practice Fax: 928-532-1129

1104154269 — DEREK R FLAKE PT
Practice Location Address:

4830 HIGHWAY 260 STE 105
LAKESIDE, AZ
85929-5851

Practice Phone: 928-532-1221
Practice Fax: 928-532-1227

1194132613 — JEFFREY M REAGAN MD PLLC
Practice Location Address:

4830 HIGHWAY 260 STE 103
LAKESIDE, AZ
85929-5851

Practice Phone: 928-537-8777
Practice Fax: 928-537-1914

1215425202 — MARY KATHERINE HEGARTY PT
Practice Location Address:

4830 HIGHWAY 260 STE 105
LAKESIDE, AZ
85929-5851

Practice Phone: 928-532-1221
Practice Fax:

1114583291 — MR. STEVEN K STRUTHERS PA-C
Practice Location Address:

4830 HIGHWAY 260 STE 103
LAKESIDE, AZ
85929-5851

Practice Phone: 928-537-8777
Practice Fax: 928-537-1914

Directions to “ JEFFREY MAURICE REAGAN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.