Raegan Dewilde
Raegan Dewilde is a Physician Assistant in Fairview, Oklahoma. Qualified in 2020, 6 years ago. Practices with Fairview Regional Medical Center Authority, a 4-clinician group and accepts Medicare assignment.
- Years since qualifying
- 6
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
523 E State RdFairview, OK 73737-1453
Phone: (580) 227-2585
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1780226084 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | October 8, 2019 |
| Last updated in NPPES | June 8, 2022 |
| Certification date | June 8, 2022 |
| Mailing address | 716 S Hickory St, Sapulpa, OK 74066-5130 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2020 (6 years in practice) |
| Group practice | Fairview Regional Medical Center Authority — 4 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |