Provider Demographics
NPI:1730285966
Name:RAGON, ANDREW EVERETT (DC)
Entity Type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:EVERETT
Last Name:RAGON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 MASSILLON RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-5981
Mailing Address - Country:US
Mailing Address - Phone:330-896-2030
Mailing Address - Fax:330-899-0527
Practice Address - Street 1:3333 MASSILLON RD
Practice Address - Street 2:SUITE 206
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-5981
Practice Address - Country:US
Practice Address - Phone:330-896-2030
Practice Address - Fax:330-899-0527
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2012-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3692111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2645258Medicaid
OHRA4305861Medicare PIN
V08223Medicare UPIN