| Dylan Reagan, | |
|
1100 Mercer Ave, Decatur, IN 46733-2303 | |
| (260) 724-2145 | |
| Not Available |
| Full Name | Dylan Reagan |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1100 Mercer Ave, Decatur, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962141648 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 28225385A (Indiana) | Primary |
| Entity Name | Adams County Memorial Hospital |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1689696148 PECOS PAC ID: 0941198253 Enrollment ID: O20041001000326 |
| Entity Name | Iceland Anesthesia Management Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912578667 PECOS PAC ID: 7618372996 Enrollment ID: O20210825000860 |
| Mailing Address | Practice Location Address |
|---|---|
| Dylan Reagan, Po Box 151, Decatur, IN 46733-0151 Ph: (260) 724-2145 | Dylan Reagan, 1100 Mercer Ave, Decatur, IN 46733-2303 Ph: (260) 724-2145 |
Michael Kevin Kobs, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1100 Mercer Ave, Decatur, IN 46733 Phone: 260-724-2145 | |
Haven Dove, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1100 Mercer Ave, Decatur, IN 46733 Phone: 260-724-2145 |