Provider Demographics
NPI:1386532711
Name:RAGAN, VICTOR LEROY
Entity type:Individual
Prefix:
First Name:VICTOR
Middle Name:LEROY
Last Name:RAGAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 SHAPLEY DR
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:DE
Mailing Address - Zip Code:19977-6843
Mailing Address - Country:US
Mailing Address - Phone:215-218-8613
Mailing Address - Fax:
Practice Address - Street 1:371 SHAPLEY DR
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-6843
Practice Address - Country:US
Practice Address - Phone:215-906-4166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-25
Last Update Date:2025-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service