Individual
TIMOTHY CHAD FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
15024 MARTIN LUTHER KING JR BLVD, GULFPORT, MS 39501-8306
(205) 783-7970
(205) 783-7695
Mailing address
10467 CORPORATE DR, GULFPORT, MS 39503-4634
(228) 374-2494
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-117395
AL
Other
Enumeration date
03/13/2014
Last updated
09/16/2024
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