Individual
DR. CHRISTOPHER CHARLES RYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
225 E WASHINGTON AVE, JONESBORO, AR 72401-3111
(870) 910-6654
(870) 932-0526
Mailing address
250 N SHADELAND AVE, SUITE 130 PROVIDER ENROLLMENT, INDIANAPOLIS, IN 46219-4959
(317) 715-6401
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E9628
AR
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201306130
—
IN
Enumeration date
07/10/2010
Last updated
11/17/2023
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