Provider Demographics
NPI:1922035641
Name:FRYE, JOHN W (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:W
Last Name:FRYE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:545 N RIVER ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18702-2600
Mailing Address - Country:US
Mailing Address - Phone:570-288-6616
Mailing Address - Fax:570-288-6860
Practice Address - Street 1:545 N RIVER ST
Practice Address - Street 2:SUITE 100
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18702-2600
Practice Address - Country:US
Practice Address - Phone:570-288-6616
Practice Address - Fax:570-288-6860
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD017900E207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0008931840007Medicaid
PA0008931840007Medicaid
PAC29815Medicare UPIN