Provider Demographics
NPI:1952804288
Name:RAGSDALE, CALLEN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CALLEN
Middle Name:
Last Name:RAGSDALE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:CALLEN
Other - Middle Name:
Other - Last Name:HUEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2448 E 81ST ST STE 1520
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74137-4212
Mailing Address - Country:US
Mailing Address - Phone:918-900-2520
Mailing Address - Fax:
Practice Address - Street 1:2448 E 81ST ST STE 1520
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-4212
Practice Address - Country:US
Practice Address - Phone:918-900-2520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2902207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery