Provider Demographics
NPI:1659774503
Name:FRYECARE PHYSICIANS , LLC
Entity Type:Organization
Organization Name:FRYECARE PHYSICIANS , LLC
Other - Org Name:FRYECARE LUNG CENTER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:REGIONAL CFO, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:WESLEY
Authorized Official - Middle Name:O
Authorized Official - Last Name:JAMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-265-5009
Mailing Address - Street 1:PO BOX 100183
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30384-0183
Mailing Address - Country:US
Mailing Address - Phone:828-322-2005
Mailing Address - Fax:828-322-2159
Practice Address - Street 1:915 TATE BLVD SE
Practice Address - Street 2:SUITE 182
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28602-4042
Practice Address - Country:US
Practice Address - Phone:828-322-2005
Practice Address - Fax:828-322-2159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty