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General NPI Number Information
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NPI Number | 1649414202
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Entity Type | Individual
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Provider Name | JOSEPH BRETT BRYANT M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/27/2009
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Last Update Date | 10/22/2019
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Provider Practice Location Address
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Address Line | 699 CHURCH ST NE SUITE 500 KENNESTONE OB/GYN
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City | MARIETTA
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State | GA
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Zip | 30060-1110
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Country | US
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Telephone | 770-793-9750
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Fax |
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Provider Business Mailing Address
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Address Line | 699 CHURCH ST NE SUITE 500 KENNESTONE OB/GYN
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City | MARIETTA
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State | GA
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Zip | 30060-1110
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Country | US
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Telephone | 770-793-9750
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 068987
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License Number State | GA
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