Provider Demographics
NPI:1336535970
Name:RAGUE, JOHN I (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:RAGUE
Suffix:I
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 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1400 E BOULDER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-5533
Practice Address - Country:US
Practice Address - Phone:719-365-6820
Practice Address - Fax:719-365-6595
Is Sole Proprietor?:No
Enumeration Date:2015-04-10
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0062296208M00000X, 207P00000X, 2083T0002X, 207PT0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No2083T0002XAllopathic & Osteopathic PhysiciansPreventive MedicineMedical Toxicology
No207PT0002XAllopathic & Osteopathic PhysiciansEmergency MedicineMedical Toxicology