Healthcare Provider Details

I. General information

NPI: 1760394043
Provider Name (Legal Business Name): LEAH C. FRYAR, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 AUSTIN PEAY HWY
MEMPHIS TN
38128-2502
US

IV. Provider business mailing address

PO BOX 11511
MEMPHIS TN
38111-0511
US

V. Phone/Fax

Practice location:
  • Phone: 901-213-5400
  • Fax: 901-213-5532
Mailing address:
  • Phone: 901-842-1480
  • Fax: 901-844-1439

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: LEAH FRYAR
Title or Position: OWNER
Credential: MD
Phone: 901-842-1480