Provider Demographics
NPI:1629278031
Name:FRYE, PAUL FRAZIER (MD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:FRAZIER
Last Name:FRYE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:NA
Other - Middle Name:NA
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3075 W SILVERHILL LN
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-1176
Mailing Address - Country:US
Mailing Address - Phone:559-349-1046
Mailing Address - Fax:559-492-3672
Practice Address - Street 1:3075 W SILVERHILL LN
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-1176
Practice Address - Country:US
Practice Address - Phone:559-349-1046
Practice Address - Fax:559-492-3672
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-23
Last Update Date:2016-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG29039208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA43940Medicare UPIN