Provider Demographics
NPI:1912905589
Name:SHRAGER, JOSEPH D (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:SHRAGER
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 1:2701 E ELVIRA RD
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85756-7124
Mailing Address - Country:US
Mailing Address - Phone:520-874-3500
Mailing Address - Fax:
Practice Address - Street 1:3838 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1478
Practice Address - Country:US
Practice Address - Phone:520-694-2873
Practice Address - Fax:520-694-1820
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD 006191-E207N00000X
AZ41219207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ399983Medicaid
056659Medicare ID - Type Unspecified
AZ399983Medicaid
B-32838Medicare UPIN