Provider Demographics
NPI:1689960924
Name:RAGSDALE, KELSEY JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:KELSEY
Middle Name:JEAN
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:KELSEY
Other - Middle Name:JEAN
Other - Last Name:LUEGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:4400 BROADWAY
Mailing Address - Street 2:SUITE 206
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3498
Mailing Address - Country:US
Mailing Address - Phone:816-561-8100
Mailing Address - Fax:
Practice Address - Street 1:4400 BROADWAY
Practice Address - Street 2:SUITE 206
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3498
Practice Address - Country:US
Practice Address - Phone:816-561-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-24
Last Update Date:2022-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014014743208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics