Provider Demographics
NPI:1770588253
Name:RAGLAND, CHARLES W (MD)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:W
Last Name:RAGLAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5675 ROE BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:ROELAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2538
Mailing Address - Country:US
Mailing Address - Phone:913-432-2080
Mailing Address - Fax:913-432-5183
Practice Address - Street 1:8800 W 75TH ST
Practice Address - Street 2:STE 300
Practice Address - City:SHAWNEE MISSION
Practice Address - State:KS
Practice Address - Zip Code:66204-4001
Practice Address - Country:US
Practice Address - Phone:913-722-4240
Practice Address - Fax:913-432-8463
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2021-05-06
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Provider Licenses
StateLicense IDTaxonomies
KS0418928207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100165650AMedicaid
KSF214542Medicare PIN
KSF204542Medicare PIN
KS100165650AMedicaid
KSF200000Medicare PIN