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General NPI Number Information
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NPI Number | 1083687230
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Entity Type | Individual
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Provider Name | WILLIAM TRUMP FRYE OD
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Gender | Male
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Dates
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Enumeration Date | 02/08/2006
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Last Update Date | 03/12/2010
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Provider Practice Location Address
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Address Line | 1802 N JACKSON ST STE# 830
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City | TULLAHOMA
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State | TN
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Zip | 37388-8218
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Country | US
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Telephone | 931-455-2020
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Fax | 931-455-5467
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Provider Business Mailing Address
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Address Line | 321 MARKS AVE
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City | TULLAHOMA
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State | TN
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Zip | 37388-6213
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Country | US
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Telephone | 931-455-3262
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Fax | 931-455-5467
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 657
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License Number State | TN
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