MEDICARE: JOEL BRYAN RAGLAND MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207T00000X	Neurological Surgery Physician	MD25341	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386633402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOEL BRYAN RAGLAND MD

Provider Business Mailing Address
First Line	:	9314 PARK WEST BLVD
Second Line	:	200 MEDICAL ARTS BLDG
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4353
Country	:	US
Telephone Number	:	865-694-0577
Fax Number	:	865-694-4720

Provider Business Practice Location Address
First Line	:	9314 PARK WEST BLVD
Second Line	:	200 MEDICAL ARTS BLDG
City	:	KNOXVILLE
State	:	TN
Zip	:	37923-4353
Country	:	US
Telephone Number	:	865-694-0577
Fax Number	:	865-694-4720

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/20/2005
Last Update Date	:	09/09/2010

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