Provider Demographics
NPI:1063162923
Name:SEVERS, TORI REAGAN (MD)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:REAGAN
Last Name:SEVERS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 S MAIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-4358
Mailing Address - Country:US
Mailing Address - Phone:937-436-3117
Mailing Address - Fax:
Practice Address - Street 1:1023 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-4358
Practice Address - Country:US
Practice Address - Phone:937-436-3117
Practice Address - Fax:937-436-0730
Is Sole Proprietor?:No
Enumeration Date:2022-03-24
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.153359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine