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DR. BRUCE JACKSON BRYAN MD

>> Surgery >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1700847050

Individual Registrant:
DR. BRUCE JACKSON BRYAN MD
Gender: M
Not Sole Proprietor

Location and contact information for practice:
163 W WHITE MOUNTAIN HWY SUITE D PINETOP, AZ 85935-2850 US
Tel: 928-367-1200  Fax: 928-367-1205

Contact information for business:
PO BOX 2850 163 WHITE MOUNTAIN HWY SUITE D PINETOP, AZ 85935-2850 US
Tel: 928-367-1200  Fax: 928-367-1205

Registration Information:
NPI: 1700847050
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y208600000XAllopathic & Osteopathic Physicians
Surgery
AZ20232

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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