Provider Demographics
NPI:1265511323
Name:AUTH, REGINA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:REGINA
Middle Name:ELIZABETH
Last Name:AUTH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 RIVERMONT AVE APT 12
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24503-1350
Mailing Address - Country:US
Mailing Address - Phone:434-384-7820
Mailing Address - Fax:
Practice Address - Street 1:SAINT MARYS MEDICAL CTR
Practice Address - Street 2:3700 WASHINGTON AVENUE
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47750-0001
Practice Address - Country:US
Practice Address - Phone:812-485-1894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101042453207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAB93362Medicare UPIN