Provider Demographics
NPI:1356334965
Name:ANDERSON, REAGAN B (DO)
Entity type:Individual
Prefix:MR
First Name:REAGAN
Middle Name:B
Last Name:ANDERSON
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Gender:M
Credentials:DO
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Mailing Address - Street 1:8580 SCARBOROUGH DR
Mailing Address - Street 2:SUITE 225
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-7586
Mailing Address - Country:US
Mailing Address - Phone:719-531-5400
Mailing Address - Fax:719-531-9545
Practice Address - Street 1:8580 SCARBOROUGH DR
Practice Address - Street 2:SUITE 225
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-7586
Practice Address - Country:US
Practice Address - Phone:719-531-5400
Practice Address - Fax:719-531-9545
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2020-09-03
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Provider Licenses
StateLicense IDTaxonomies
CODR.0048132207ND0101X
CO48132207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery