Healthcare Provider Details

I. General information

NPI: 1710881800
Provider Name (Legal Business Name): ABIGAIL RAY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

565 RADIO HILL RD
MARION VA
24354-6587
US

IV. Provider business mailing address

33051 SPRING GARDEN DR
GLADE SPRING VA
24340-5087
US

V. Phone/Fax

Practice location:
  • Phone: 276-944-6342
  • Fax:
Mailing address:
  • Phone: 276-608-4122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: