Individual
DR. CHARLES FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
313185
LA
207R00000X
Internal Medicine Physician
MS17625
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009945355
—
AL
01
—
110245945
MEDICARE RAILROAD
—
01
—
646000515E
BLUE CROSS OF MS
—
05
—
CF05970562
—
MS
Enumeration date
01/15/2007
Last updated
01/23/2020
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