Rex Thomas Averill, MD

Individual provider Active NPI Urology Physician · Port Angeles, WA

NPI 1124054697 · NPPES record last updated Jul 21, 2022

Key facts

NPI
1124054697
Entity type
Individual (NPI type 1)
Primary specialty
Urology Physician 208800000X
License
MD00019093 (WA)
Practice address
907 Georgiana St
Port Angeles, WA 98362-3911
Phone
(360) 565-0999
Fax
(360) 565-9251
NPI assigned
Jun 24, 2006
Sex
Male
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Clallam County Public Hospital District 2 Past
since Aug 1, 2010
Accepting new patients
Clallam County Public Hospital District 2 Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: raverill280258@wm.providencedirect.org

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD00019093 WA Yes

Addresses

Primary practice location

907 Georgiana St
Port Angeles, WA 98362-3911

Mailing address

PO Box 850
Port Angeles, WA 98362-0146
Phone (360) 565-9237

Other providers in Port Angeles, WA

All providers in Port Angeles, WA · Urology Physician in Washington

Sources for this page

Verify at the official NPI Registry.