Provider Demographics
NPI:1457617011
Name:FRYE, JOSEPH W II (DO)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:W
Last Name:FRYE
Suffix:II
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W OAKLAND AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37604-2192
Mailing Address - Country:US
Mailing Address - Phone:423-302-6565
Mailing Address - Fax:
Practice Address - Street 1:1980 HOLTON AVE E
Practice Address - Street 2:SUITE 202
Practice Address - City:BIG STONE GAP
Practice Address - State:VA
Practice Address - Zip Code:24219-3366
Practice Address - Country:US
Practice Address - Phone:276-523-8973
Practice Address - Fax:276-523-8974
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3034208100000X
VA0102204484208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN103I255503Medicare PIN
VAVVL418B288Medicare PIN