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General NPI Number Information
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NPI Number | 1174750376
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Entity Type | Individual
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Provider Name | JEREMY THOMAS RAGLAND MD
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Gender | Male
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Dates
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Enumeration Date | 06/15/2009
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Last Update Date | 06/16/2025
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Provider Practice Location Address
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Address Line | 677 CHURCH ST NE
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City | MARIETTA
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State | GA
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Zip | 30060-1101
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Country | US
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Telephone | 404-312-9771
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Fax |
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Provider Business Mailing Address
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Address Line | 439 SHADOWLAWN RD SE
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City | MARIETTA
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State | GA
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Zip | 30067-4326
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Country | US
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Telephone | 404-312-9771
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Fax |
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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 | 2084A2900X
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Taxonomy Name | Neurocritical Care Physician
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License Number | Q5539
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 262753
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License Number State | NY
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD221743
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License Number State | OR
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Taxonomy #4
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | MD61575693
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License Number State | WA
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Taxonomy #5
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | ME159336
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | ME159336
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License Number State | FL
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