Healthcare Provider Details

I. General information

NPI: 1790586626
Provider Name (Legal Business Name): CAYCE ANDERSON FRY PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8635 MIDDLEBROOK PIKE
KNOXVILLE TN
37923-1612
US

IV. Provider business mailing address

1275 DICK LONAS RD UNIT 101
KNOXVILLE TN
37909-1383
US

V. Phone/Fax

Practice location:
  • Phone: 865-824-0079
  • Fax: 833-908-2101
Mailing address:
  • Phone: 865-584-4747
  • Fax: 865-381-1509

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number6639
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: