Healthcare Provider Details

I. General information

NPI: 1750313748
Provider Name (Legal Business Name): CHRIS N BRYANT D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 03/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 NICHOLASVILLE RD SUITE 1
LEXINGTON KY
40503-2520
US

IV. Provider business mailing address

2130 NICHOLASVILLE RD SUITE 1
LEXINGTON KY
40503-2520
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-7313
  • Fax: 859-260-1007
Mailing address:
  • Phone: 859-278-7313
  • Fax: 859-260-1007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberKY0245
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: