Fry, Jack Robert

Fry, Jack Robert is an individual health care provider with primary practice located at 7333 Smiths Mill Rd , New Albany OH 43054-9291. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Fry, Jack Robert can be contacted via phone (614) 775-6675.

Contact Information

Primary practice address
7333 Smiths Mill Rd New Albany OH 43054-9291
Phone: (614) 775-6675
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X RN161169 Ohio

Profile Details

NPI number 1023032141
LBN Legal business name Fry, Jack Robert
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023032141 NPPES
Ohio MEDICAID 2044719

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