Provider Demographics
NPI:1255318820
Name:FRIDDELL, ROY ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:ANTHONY
Last Name:FRIDDELL
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:725 GLENWOOD DR
Mailing Address - Street 2:SUITE 882
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37404-1163
Mailing Address - Country:US
Mailing Address - Phone:423-698-2229
Mailing Address - Fax:423-624-2652
Practice Address - Street 1:725 GLENWOOD DR
Practice Address - Street 2:SUITE 882
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37404-1163
Practice Address - Country:US
Practice Address - Phone:423-698-2229
Practice Address - Fax:423-624-2652
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2008-08-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN29835208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics