=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902801483
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRYAN DAVID USLICK MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/20/2005
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1880 QUIET CV
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28304-3857
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-323-2477
-----------------------------------------------------
Fax | 910-323-5931
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 87388
-----------------------------------------------------
City | FAYETTEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28304-7388
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-323-2477
-----------------------------------------------------
Fax | 910-323-5931
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RG0100X
-----------------------------------------------------
Taxonomy Name | Gastroenterology Physician
-----------------------------------------------------
License Number | 9501136
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------