Provider Demographics
NPI:1659482305
Name:FRY, JAMES ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALAN
Last Name:FRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1916 PATTERSON ST STE 104
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-2154
Mailing Address - Country:US
Mailing Address - Phone:615-320-1583
Mailing Address - Fax:615-800-8892
Practice Address - Street 1:1916 PATTERSON ST # 104
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-2120
Practice Address - Country:US
Practice Address - Phone:615-320-1583
Practice Address - Fax:615-800-8892
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN0235382084N0402X
TN235382084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child NeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3067965Medicaid
TNE04442Medicare UPIN
TN3067965Medicaid