Healthcare Provider Details

I. General information

NPI: 1184204976
Provider Name (Legal Business Name): WILLIAM FRY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2021
Last Update Date: 06/26/2026
Certification Date: 06/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 CHARLOTTE AVE
NASHVILLE TN
37209-4035
US

IV. Provider business mailing address

2801 CHARLOTTE AVE
NASHVILLE TN
37209-4035
US

V. Phone/Fax

Practice location:
  • Phone: 888-245-0702
  • Fax:
Mailing address:
  • Phone: 888-245-0702
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberTBD
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: