Provider Demographics
NPI:1487458253
Name:BOX, REAGAN (MD)
Entity type:Individual
Prefix:
First Name:REAGAN
Middle Name:
Last Name:BOX
Suffix:
Gender:X
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:979 E 3RD ST STE C720
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37403-3329
Mailing Address - Country:US
Mailing Address - Phone:423-778-7517
Mailing Address - Fax:
Practice Address - Street 1:979 E 3RD ST STE C720
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37403-3329
Practice Address - Country:US
Practice Address - Phone:423-778-7517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-02
Last Update Date:2025-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program