Healthcare Provider Details

I. General information

NPI: 1790190700
Provider Name (Legal Business Name): CHRISTOPHER RYAN JAMES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2014
Last Update Date: 08/18/2020
Certification Date: 08/18/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37026 US HIGHWAY 19 N
PALM HARBOR FL
34684-1109
US

IV. Provider business mailing address

37026 US HIGHWAY 19 N
PALM HARBOR FL
34684-1109
US

V. Phone/Fax

Practice location:
  • Phone: 727-201-1007
  • Fax: 727-937-7199
Mailing address:
  • Phone: 727-938-1935
  • Fax: 727-937-7199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number036150329
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number036150329
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: