Healthcare Provider Details

I. General information

NPI: 1801989918
Provider Name (Legal Business Name): R. DON BRYAN, M.D. PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1022 1ST ST NORTH SUITE 203
ALABASTER AL
35007
US

IV. Provider business mailing address

PO BOX 1857 1022 1ST ST NORTH SUITE 203
ALABASTER AL
35007
US

V. Phone/Fax

Practice location:
  • Phone: 205-663-5840
  • Fax: 205-664-2159
Mailing address:
  • Phone: 205-663-5840
  • Fax: 205-664-2159

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: SUSAN KITCHENS
Title or Position: NURSE OFFICE MANAGER
Credential:
Phone: 205-663-5840