Provider Demographics
NPI:1194695585
Name:RAY, CHRISTOPHER DYLAN
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:DYLAN
Last Name:RAY
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 1:309 HOLLIWELL CHASE LN
Mailing Address - Street 2:
Mailing Address - City:MARYVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37804-2998
Mailing Address - Country:US
Mailing Address - Phone:865-696-5748
Mailing Address - Fax:
Practice Address - Street 1:309 HOLLIWELL CHASE LN
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:TN
Practice Address - Zip Code:37804-2998
Practice Address - Country:US
Practice Address - Phone:865-696-5748
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-10
Last Update Date:2025-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical