Healthcare Provider Details

I. General information

NPI: 1063402022
Provider Name (Legal Business Name): CHRISTY G MCGHEE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/21/2005
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 JOHNSTON MEMORIAL DR
ABINGDON VA
24211-7664
US

IV. Provider business mailing address

4105 FORT HENRY DR STE 300
KINGSPORT TN
37663-2256
US

V. Phone/Fax

Practice location:
  • Phone: 423-844-6450
  • Fax: 423-844-6499
Mailing address:
  • Phone: 423-239-1550
  • Fax: 423-239-1544

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number786
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: