Organization
RICHARD E. FRY, OD, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD FRY O.D. (OPTOMETRIST)
(910) 298-3001
Entity
Organization
Contact information
Practice address
110 S THOMAS ST, BEULAVILLE, NC 28518-8810
(910) 298-3001
(910) 298-8149
Mailing address
110 S THOMAS ST, BEULAVILLE, NC 28518-8810
(910) 298-3001
(910) 298-8149
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1189
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09296
BLUE CROSS AND BLUE SHIELD
NC
05
—
8909296
—
NC
Enumeration date
02/15/2012
Last updated
04/02/2012
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