Healthcare Provider Details

I. General information

NPI: 1962665489
Provider Name (Legal Business Name): JOHN W RAGSDALE IV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2008
Last Update Date: 12/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UK DIVISION OF HOSPITAL MEDICINE 800 ROSE STREET, MN604
LEXINGTON KY
40536-0294
US

IV. Provider business mailing address

UK GENERAL INTERNAL MEDICINE 900 S. LIMESTONE, CTW 306
LEXINGTON KY
40536-0200
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6047
  • Fax: 859-257-3873
Mailing address:
  • Phone: 859-257-5499
  • Fax: 859-257-2605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number42208
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number42208
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: