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General NPI Number Information
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NPI Number | 1356393904
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Entity Type | Organization
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Legal Business Name | RONALD W. BRYAN M.D.,P.C.
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 04/03/2008
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Provider Practice Location Address
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Address Line | 9330 PARK WEST BLVD SUITE #103
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City | KNOXVILLE
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State | TN
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Zip | 37923-4309
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Country | US
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Telephone | 865-690-7820
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Fax | 865-539-6262
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Provider Business Mailing Address
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Address Line | 9330 PARK WEST BLVD
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City | KNOXVILLE
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State | TN
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Zip | 37923-4309
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Country | US
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Telephone | 865-690-7820
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Fax | 865-539-6262
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD WILLIAM BRYAN
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Credential | M.D.
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Telephone | 865-690-7820
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 0000013662
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License Number State | TN
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