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Individual

MR. RUSSELL L FRY II

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5187 US ROUTE 60 E, STE 6, HUNTINGTON, WV 25705-2076
(304) 691-8800
(304) 302-0221
Mailing address
5187 US ROUTE 60 E, STE 6, HUNTINGTON, WV 25705-2076
(304) 691-8800
(304) 302-0221

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
200501699
NC
207W00000X
Ophthalmology Physician
Primary
21418
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
5902537
NC
Enumeration date
04/12/2006
Last updated
12/02/2021
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