Provider Demographics
NPI:1508954959
Name:OVERBAY, CHRISTOPHER BRIAN (PA)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:BRIAN
Last Name:OVERBAY
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23740
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37933-1740
Mailing Address - Country:US
Mailing Address - Phone:865-549-4340
Mailing Address - Fax:865-549-4341
Practice Address - Street 1:10820 PARKSIDE DRIVE
Practice Address - Street 2:BAPTIST HOSPITAL WEST DEPT OF SURGERY
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934
Practice Address - Country:US
Practice Address - Phone:865-218-7165
Practice Address - Fax:865-218-7170
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2020-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9110557363A00000X
TNPA723363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4020004OtherBCBSTN
TN4167585OtherBCBS
TN3704598Medicaid
TNTN0163OtherUHC - JOHN DEERE
TN3665185Medicaid
TN3668134Medicaid
TN4167585OtherBCBS
TN3668134Medicaid
TN3668134Medicare ID - Type UnspecifiedMEDICARE
TN3665185Medicare PIN