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General NPI Number Information
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NPI Number | 1851487417
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Entity Type | Individual
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Provider Name | THOMAS R. BRYANT M.D.
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Gender | Male
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 11/06/2012
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Provider Practice Location Address
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Address Line | 3004 ALLISON BONNETT MEMORIAL DR
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City | HUEYTOWN
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State | AL
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Zip | 35023-2317
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Country | US
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Telephone | 205-491-3299
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Fax | 205-744-8751
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Provider Business Mailing Address
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Address Line | PO BOX 11407 DEPT 2043
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City | BIRMINGHAM
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State | AL
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Zip | 35246-2043
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Country | US
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Telephone | 205-491-3299
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Fax | 205-744-8751
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11392
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 11392
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License Number State | AL
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