| Michelle L. Frye, O.d. Llc | |
|
902 W Wayne St Fort Wayne IN 46802-3976 | |
| (260) 422-9421 | |
| Not Available |
| Full Name | Michelle L. Frye, O.d. Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 902 W Wayne St, Fort Wayne, Indiana |
| Authorized Official Name and Position | Michelle Frye (OWNER) |
| Authorized Official Contact | 6042294221 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Michelle L. Frye, O.d. Llc 2324 County Road 56 Auburn IN 46706-9507 Ph: (260) 925-4893 | Michelle L. Frye, O.d. Llc 902 W Wayne St Fort Wayne IN 46802-3976 Ph: (260) 422-9421 |
| NPI Number | 1437517968 |
|---|---|
| Provider Enumeration Date | 01/28/2016 |
| Last Update Date | 09/01/2021 |
| Medicare PECOS PAC ID | 1658677406 |
|---|---|
| Medicare Enrollment ID | O20160304001034 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437517968 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 18003461B (Indiana) | Primary |
| Provider Name | Michelle Frye |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1063610517 PECOS PAC ID: 7517068679 Enrollment ID: I20160304001091 |
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