MEDICARE: ZACK ELLIS BRYANT 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
1	2083P0500X	Preventive Medicine/Occupational Environmental Medicine Physician	A158462	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1770945370
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZACK ELLIS BRYANT M.D.

Provider Business Mailing Address
First Line	:	3401 MALLORY LN
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2025
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3401 MALLORY LN
Second Line	:
City	:	FRANKLIN
State	:	TN
Zip	:	37067-2025
Country	:	US
Telephone Number	:	615-695-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2016
Last Update Date	:	01/13/2026

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