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NPI Code Detail

MEDICARE: DR. CAREY WALLACE FRIX M.D.

MEDICARE:  DR. CAREY WALLACE FRIX  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianMD0000034836TN

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00065503OTHERTNRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1235124223
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAREY WALLACE FRIX M.D.
Provider Business Mailing Address
First Line : 116 W MAIN ST
Second Line :
City : HENDERSON
State : TN
Zip : 38340-2231
Country : US
Telephone Number : 731-989-0001
Fax Number : 731-989-5151
Provider Business Practice Location Address
First Line : 116 W MAIN ST
Second Line :
City : HENDERSON
State : TN
Zip : 38340-2231
Country : US
Telephone Number : 731-989-0001
Fax Number : 731-989-5151
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/15/2005
Last Update Date : 01/26/2021

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Directions to “ DR. CAREY WALLACE FRIX M.D.” Practice Location

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