Healthcare Provider Details

I. General information

NPI: 1376836577
Provider Name (Legal Business Name): JAMES WILLIAM RAGINS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 01/10/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 CASCADE PKWY SW KAISER PERMANENTE CASCADE MEDICAL CENTER
ATLANTA GA
30311-3090
US

IV. Provider business mailing address

3495 PIEDMONT RD NE NINE PIEDMONT CENTER
ATLANTA GA
30305-1717
US

V. Phone/Fax

Practice location:
  • Phone: 404-505-4006
  • Fax:
Mailing address:
  • Phone: 404-364-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number71857
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: