Provider Demographics
NPI:1891742805
Name:FRY, ALLAND GORDON III (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLAND
Middle Name:GORDON
Last Name:FRY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:13601 BRUCE B DOWNS BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-4657
Mailing Address - Country:US
Mailing Address - Phone:813-971-6909
Mailing Address - Fax:813-971-6985
Practice Address - Street 1:13601 BRUCE B DOWNS BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-4657
Practice Address - Country:US
Practice Address - Phone:813-971-6909
Practice Address - Fax:813-971-6985
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLME96015207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G29781Medicare UPIN