Healthcare Provider Details

I. General information

NPI: 1154902864
Provider Name (Legal Business Name): JEAN-PAUL BRYANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3800 RESERVOIR RD NW
WASHINGTON DC
20007-2113
US

IV. Provider business mailing address

2000 2ND ST SW APT PH01
WASHINGTON DC
20024-4142
US

V. Phone/Fax

Practice location:
  • Phone: 202-444-2000
  • Fax:
Mailing address:
  • Phone: 904-315-3595
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberMD60005449
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: