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Raegan Dewilde
Medical Physician Assistant in Fairview, Oklahoma
NPI 1780226084

Raegan Dewilde is a Medical Physician Assistant based in Sapulpa, OK and is specialized in Medical. Raegan Dewilde practices in Fairview, OK. The NPI Number for Raegan Dewilde is 1780226084 and holds a License No. (Oklahoma).

The current practice location address for Raegan Dewilde is 523 E State Rd, Fairview, OK and can be reached out via phone at 580-227-2585.

Location: 523 E State Rd, Fairview, OK, 74066-5130
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1780226084
Provider Name
Raegan Dewilde
Credential
Provider Entity Type
Individual
Gender
Female
Address
523 E State Rd, Fairview, OK, 74066-5130
Phone Number
580-227-2585
Fax Number
Provider Enumeration Date
10/08/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
523 E State Rd
City
Fairview
State
Oklahoma
Zip
73737-1453
Phone Number
580-227-2585
Fax Number
person
Provider Business Mailing Address Details
Address
523 E State Rd
City
Fairview
State
Oklahoma
Zip
73737-1453
Phone Number
580-227-2585
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
363AM0700X
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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