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General NPI Number Information
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NPI Number | 1508250937
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Entity Type | Individual
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Provider Name | JOAN BRYANT DO
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Gender | Female
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 07/25/2022
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Provider Practice Location Address
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Address Line | 2669 SCENIC DR
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8700
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Country | US
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Telephone | 575-443-7846
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Fax |
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Provider Business Mailing Address
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Address Line | 2669 SCENIC DR
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City | ALAMOGORDO
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State | NM
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Zip | 88310-8700
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 29546
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 29546
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License Number State | NE
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