Healthcare Provider Details

I. General information

NPI: 1588678742
Provider Name (Legal Business Name): LUKE RAGAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 11/03/2023
Certification Date: 12/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2865 N REYNOLDS RD BUILDING A
TOLEDO OH
43615-2068
US

IV. Provider business mailing address

333 N SUMMIT ST FL 7
TOLEDO OH
43604-1531
US

V. Phone/Fax

Practice location:
  • Phone: 419-578-7200
  • Fax: 419-537-5600
Mailing address:
  • Phone: 419-578-7551
  • Fax: 419-537-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35077076
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35077076
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: