Individual
DR. CHARLES FRYE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5510
(228) 809-5519
Mailing address
2809 DENNY AVE, PASCAGOULA, MS 39581-5301
(228) 809-5510
(228) 809-5519
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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