Provider Demographics
NPI:1861454522
Name:DEGNER, REX ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:REX
Middle Name:ANTHONY
Last Name:DEGNER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5700 SOUTHWYCK BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1509
Mailing Address - Country:US
Mailing Address - Phone:800-288-8325
Mailing Address - Fax:419-866-5453
Practice Address - Street 1:1701 EAST 23RD
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502
Practice Address - Country:US
Practice Address - Phone:620-665-2335
Practice Address - Fax:620-513-3832
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS22905207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
058343OtherBLUE CROSS BLUE SHIELD
220029347OtherRAILROAD MEDICARE
KS100332840BMedicaid
KS22905OtherKANSAS LICENSE
058343OtherBLUE CROSS BLUE SHIELD
KS100332840BMedicaid