Provider Demographics
NPI:1720057417
Name:SEGAR, REGINALD PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:REGINALD
Middle Name:PATRICK
Last Name:SEGAR
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:PO BOX 967
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535
Mailing Address - Country:US
Mailing Address - Phone:337-546-0424
Mailing Address - Fax:337-457-7989
Practice Address - Street 1:631 WEST MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535
Practice Address - Country:US
Practice Address - Phone:337-546-0424
Practice Address - Fax:337-457-7989
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA011877207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1126829Medicaid
LA5769OtherDEPT HEALTH HOSPITALS
AS5255472OtherDEA
LA54327Medicare ID - Type Unspecified
LA5769OtherDEPT HEALTH HOSPITALS