Provider Demographics
NPI:1790586626
Name:FRY, CAYCE (PA-C)
Entity type:Individual
Prefix:
First Name:CAYCE
Middle Name:
Last Name:FRY
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10827 NAPIER WAY APT 304
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37932-3181
Mailing Address - Country:US
Mailing Address - Phone:865-321-5645
Mailing Address - Fax:
Practice Address - Street 1:10827 NAPIER WAY APT 304
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37932-3181
Practice Address - Country:US
Practice Address - Phone:865-321-5645
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-24
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant