Basic Information
| Provider Information | |||||||||
| NPI: | 1790969772 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RAGSDALE | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | R.N. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3131 MEETINGHOUSE RD | ||||||||
| Address2: | APT V-11 | ||||||||
| City: | BOOTHWYN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190612947 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6104947663 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 50 N MALIN RD | ||||||||
| Address2: | |||||||||
| City: | BROOMALL | ||||||||
| State: | PA | ||||||||
| PostalCode: | 190081429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6103560800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/26/2007 | ||||||||
| LastUpdateDate: | 12/26/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163W00000X | RN334497-L | PA | N | Nursing Service Providers | Registered Nurse | 163WM0705X | RN334497-L | PA | Y | Nursing Service Providers | Registered Nurse | Medical-Surgical |
No ID Information.