Basic Information
Provider Information
NPI: 1174691166
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FRYER
FirstName: JAMES
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: R.PH.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2337 DAWNS PASS
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 37919
CountryCode: US
TelephoneNumber: 8659346786
FaxNumber: 8659346775
Practice Location
Address1: 2018 WESTERN AVE
Address2:  
City: KNOXVILLE
State: TN
PostalCode: 379215718
CountryCode: US
TelephoneNumber: 8659346786
FaxNumber: 8659346775
Other Information
ProviderEnumerationDate: 11/30/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000X4657TNY Pharmacy Service ProvidersPharmacist 

No ID Information.


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