Provider Demographics
NPI:1457703050
Name:RAGAN, DONALD JR (OD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:
Last Name:RAGAN
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:CHRISTOPHER
Other - Middle Name:MICHAEL
Other - Last Name:RAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:112 E DIXIE AVE
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:FL
Mailing Address - Zip Code:34748-6350
Mailing Address - Country:US
Mailing Address - Phone:352-787-1956
Mailing Address - Fax:352-365-6690
Practice Address - Street 1:112 E DIXIE AVE
Practice Address - Street 2:
Practice Address - City:LEESBURG
Practice Address - State:FL
Practice Address - Zip Code:34748-6350
Practice Address - Country:US
Practice Address - Phone:352-674-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOPC 5203152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist