Provider Demographics
NPI:1659011906
Name:MCPHERSON, REGINA J (MD)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:J
Last Name:MCPHERSON
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 1:5641 LAFAYETTE ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33417-5701
Mailing Address - Country:US
Mailing Address - Phone:561-781-1430
Mailing Address - Fax:
Practice Address - Street 1:5641 LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33417-5701
Practice Address - Country:US
Practice Address - Phone:561-574-4598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-01
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL34481207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine