Provider Demographics
NPI:1962477638
Name:FREY, JAMES E (PA C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:E
Last Name:FREY
Suffix:
Gender:M
Credentials:PA C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1825 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99507-5391
Mailing Address - Country:US
Mailing Address - Phone:907-522-7090
Mailing Address - Fax:907-522-7095
Practice Address - Street 1:1825 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-5391
Practice Address - Country:US
Practice Address - Phone:907-522-7090
Practice Address - Fax:907-522-7095
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-17
Last Update Date:2016-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK322363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant