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General NPI Number Information
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NPI Number | 1396365607
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Entity Type | Individual
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Provider Name | TIFFANY RAGER
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Gender | Female
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Dates
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Enumeration Date | 04/17/2020
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 11475 OLDE CABIN RD STE 200
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City | SAINT LOUIS
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State | MO
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Zip | 63141-7129
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Country | US
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Telephone | 314-991-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 11905 MARY CLAIRE DR
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City | OKLAHOMA CITY
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State | OK
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Zip | 73162-1957
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 237622
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License Number State | AK
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 7518
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2024049158
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License Number State | MO
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