Provider Demographics
NPI:1700021003
Name:FRY, JOHN RUDOLPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RUDOLPH
Last Name:FRY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 FRITH DR
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:28803
Mailing Address - Country:US
Mailing Address - Phone:828-274-3686
Mailing Address - Fax:
Practice Address - Street 1:3 FRITH DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28803-3108
Practice Address - Country:US
Practice Address - Phone:828-274-3686
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14822207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology