Provider Demographics
NPI:1043257017
Name:FORSTER, REGINA E (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:E
Last Name:FORSTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:REGINA
Other - Middle Name:E
Other - Last Name:FORSTER SCHWENK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1112 MORNING SIDE DR
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2348
Mailing Address - Country:US
Mailing Address - Phone:859-351-1310
Mailing Address - Fax:888-510-2032
Practice Address - Street 1:2716 OLD ROSEBUD RD STE 230
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8003
Practice Address - Country:US
Practice Address - Phone:859-351-1310
Practice Address - Fax:888-510-2032
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY34586207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64345861Medicaid
KY64345861Medicaid
KY0692909Medicare ID - Type Unspecified
KY0905207Medicare ID - Type Unspecified
H27009Medicare UPIN