Provider Demographics
NPI:1023146289
Name:CATHEY, REGINALD (MD)
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:
Last Name:CATHEY
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 1:2000 PERIMETER PARK DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-8442
Mailing Address - Country:US
Mailing Address - Phone:984-215-4110
Mailing Address - Fax:
Practice Address - Street 1:515 THOMPSON ST
Practice Address - Street 2:SUITE B
Practice Address - City:EDEN
Practice Address - State:NC
Practice Address - Zip Code:27288-5068
Practice Address - Country:US
Practice Address - Phone:336-623-9118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-01
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20533208600000X
SC35200208600000X
NC2008-01232208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS07128002Medicaid
MS07128002Medicaid