Ragsdale, Kim Gordon

Ragsdale, Kim Gordon is an individual health care provider with primary practice located at 1970 Roanoke Blvd , Salem VA 24153-6404. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Ragsdale, Kim Gordon can be contacted via phone (540) 982-2463.

Contact Information

Primary practice address
1970 Roanoke Blvd Salem VA 24153-6404
Phone: (540) 982-2463
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 0810001933 Virginia

Profile Details

NPI number 1912963414
LBN Legal business name Ragsdale, Kim Gordon
Credentials PH.D.
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2006
Last updated Sep 28th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1912963414 NPPES
Virginia MEDICAID 0102408883
Virginia Other 188408

Popular Providers