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General NPI Number Information
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NPI Number | 1043535941
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Entity Type | Individual
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Provider Name | EIEL E RAGSDALE MD
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Gender | Male
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Dates
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Enumeration Date | 04/02/2010
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Last Update Date | 06/12/2025
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Provider Practice Location Address
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Address Line | 3536 W GLENDALE AVE
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City | PHOENIX
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State | AZ
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Zip | 85051-8395
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Country | US
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Telephone | 480-618-0177
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Fax | 620-371-2243
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Provider Business Mailing Address
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Address Line | PO BOX 746093
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City | ATLANTA
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State | GA
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Zip | 30374-6093
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Country | US
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Telephone | 888-702-0617
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Fax | 312-929-0373
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 58861
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 205682
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License Number State | LA
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