MEDICARE: MR. DAVID RYAN KRAGEL

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	183500000X	Pharmacist	32942	TN

General Provider Information

NPI Number	:	1740563808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DAVID RYAN KRAGEL

Provider Business Mailing Address
First Line	:	228 N FAIRMONT AVE
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3768
Country	:	US
Telephone Number	:	423-586-6263
Fax Number	:	423-587-5460

Provider Business Practice Location Address
First Line	:	228 N FAIRMONT AVE
Second Line	:
City	:	MORRISTOWN
State	:	TN
Zip	:	37814-3768
Country	:	US
Telephone Number	:	423-586-6263
Fax Number	:	423-587-5460

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

Provider Enumeration Date	:	09/26/2011
Last Update Date	:	03/26/2019

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Directions to “ MR. DAVID RYAN KRAGEL ” Practice Location

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