Provider Demographics
NPI:1407284888
Name:RYU, CHI YOL (MD)
Entity Type:Individual
Prefix:
First Name:CHI
Middle Name:YOL
Last Name:RYU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1431 WILLOWBROOKE CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7201
Mailing Address - Country:US
Mailing Address - Phone:615-370-8903
Mailing Address - Fax:615-370-8903
Practice Address - Street 1:1431 WILLOWBROOKE CIR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-7201
Practice Address - Country:US
Practice Address - Phone:615-370-8903
Practice Address - Fax:615-370-8903
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-23
Last Update Date:2013-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000105512085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology