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Individual

STEPHEN W FRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
10461 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 279-1400
(423) 279-1410
Mailing address
10461 WALLACE ALLEY ST, KINGSPORT, TN 37663-3936
(423) 279-1400
(423) 279-1410

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
28164
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3801747
TN
Enumeration date
08/10/2005
Last updated
10/01/2015
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