Provider Demographics
NPI:1861493173
Name:RAGSDALE, RICHARD A (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:A
Last Name:RAGSDALE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:PALO CEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:96073-0766
Mailing Address - Country:US
Mailing Address - Phone:530-722-8505
Mailing Address - Fax:
Practice Address - Street 1:1425 MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:RED BLUFF
Practice Address - State:CA
Practice Address - Zip Code:96080-4605
Practice Address - Country:US
Practice Address - Phone:530-528-8600
Practice Address - Fax:530-528-8612
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA00G569370207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G569370Medicaid
CA00G569370Medicaid
CABR0398063OtherDEA
CA00G569370Medicare ID - Type UnspecifiedMEDICARE