Individual provider · Type 1 NPI
Raegan Dewilde
Medical Physician Assistant · Fairview, OK
NPI number
1780226084
Active
Practice location
523 E State Rd
Fairview, OK 73737-1453
Mailing address
716 S Hickory St
Sapulpa, OK 74066-5130
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Medical Physician Assistant Primary | 363AM0700X | None listed |
Medical Physician Assistant: Definition to come...
6 other providers at this address
- Fairview Regional Medical Center AuthorityCritical Access Hospital Fairview, OK NPI 1033153309
- Fairview Regional Medical Center AuthorityCritical Access Hospital Fairview, OK NPI 1053357210
- Elizabeth Ann Kimball, APN FNP-BCFamily Nurse Practitioner Fairview, OK NPI 1225465768
- Hannah Cook, PT, DPTPhysical Therapist Fairview, OK NPI 1518651199
- Larry Shane ElliottFamily Medicine Physician Fairview, OK NPI 1770933277
- Mary Bromlow, OTOccupational Therapist Fairview, OK NPI 1134817687
Other medical physician assistant providers in Fairview
About NPI 1780226084
Raegan Dewilde's National Provider Identifier is 1780226084, issued on Oct 8, 2019. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Fairview, OK. The record was last updated on Jun 8, 2022.