Basic Information
| Provider Information | |||||||||
| NPI: | 1457617011 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FRYE | ||||||||
| FirstName: | JOSEPH | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | II | ||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 W STONE DR | ||||||||
| Address2: | SUITE 6A | ||||||||
| City: | KINGSPORT | ||||||||
| State: | TN | ||||||||
| PostalCode: | 376603365 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234087220 | ||||||||
| FaxNumber: | 4234087405 | ||||||||
| Practice Location | |||||||||
| Address1: | 1980 HOLTON AVE E | ||||||||
| Address2: | SUITE 202 | ||||||||
| City: | BIG STONE GAP | ||||||||
| State: | VA | ||||||||
| PostalCode: | 242193366 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2765238973 | ||||||||
| FaxNumber: | 2765238974 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/09/2012 | ||||||||
| LastUpdateDate: | 07/29/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | 0102204484 | VA | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | 208100000X | 3034 | TN | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.