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1336565431
TIMOTHY CHAD FRYE
GULFPORT, MS
NPI
1336565431
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AL 1-117395)
Enumeration Date
2014-03-13
Last Update Date
2024-09-16
Business Address
TIMOTHY CHAD FRYE CRNP
15024 MARTIN LUTHER KING JR BLVD
GULFPORT, MS 39501-8306
Phone number: 205-783-7970
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Mailing Address
TIMOTHY CHAD FRYE CRNP
10467 CORPORATE DR
GULFPORT, MS 39503-4634
Phone number: 228-374-2494
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