Provider Demographics
NPI:1629069828
Name:RAGLAND, CYNTHIA JANE (OD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:JANE
Last Name:RAGLAND
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:JANE
Other - Last Name:BAUER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:236 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:MARSHALLTOWN
Mailing Address - State:IA
Mailing Address - Zip Code:50158-5498
Mailing Address - Country:US
Mailing Address - Phone:641-352-3544
Mailing Address - Fax:641-752-3547
Practice Address - Street 1:236 N 13TH ST
Practice Address - Street 2:
Practice Address - City:MARSHALLTOWN
Practice Address - State:IA
Practice Address - Zip Code:50158
Practice Address - Country:US
Practice Address - Phone:641-352-3544
Practice Address - Fax:641-752-3547
Is Sole Proprietor?:No
Enumeration Date:2005-11-04
Last Update Date:2018-05-29
Deactivation Date:2018-05-15
Deactivation Code:
Reactivation Date:2018-05-29
Provider Licenses
StateLicense IDTaxonomies
IA02106152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0173096Medicaid
IA0173096Medicaid
IAI21708Medicare PIN