Provider Demographics
NPI:1639307713
Name:DABBS, RYAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:L
Last Name:DABBS
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:PO BOX 306556
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37230-6556
Mailing Address - Country:US
Mailing Address - Phone:865-694-0062
Mailing Address - Fax:865-694-7907
Practice Address - Street 1:9430 PARK WEST BLVD STE 130
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4205
Practice Address - Country:US
Practice Address - Phone:865-690-4861
Practice Address - Fax:865-560-8525
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN50970207X00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ006244Medicaid
103I207342Medicare PIN
TN3376145Medicare PIN
TN3376416Medicare PIN
TNQ006244Medicaid
0677340002Medicare NSC
0677340001Medicare NSC
0677340004Medicare NSC
103I207340Medicare PIN