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General NPI Number Information
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NPI Number | 1023313731
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Entity Type | Organization
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Legal Business Name | BRYAN ABERNATHY, M.D., P.A.
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Dates
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Enumeration Date | 01/12/2011
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Last Update Date | 07/04/2023
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Provider Practice Location Address
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Address Line | 1806 N CROSSOVER RD SUITE 4
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-2725
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Country | US
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Telephone | 479-521-5603
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Fax | 479-521-5773
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Provider Business Mailing Address
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Address Line | 1806 N CROSSOVER RD SUITE 4
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City | FAYETTEVILLE
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State | AR
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Zip | 72701-2725
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Country | US
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Telephone | 479-521-5603
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Fax | 479-521-5773
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Authorized Official
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Title or Position | DOCTOR
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Name | BRYAN E ABERNATHY
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Credential | MD
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Telephone | 479-521-5603
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | R3155
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License Number State | AR
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