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General NPI Number Information
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NPI Number | 1912264755
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Entity Type | Individual
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Provider Name | BRYAN JOEL SIRMON M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/18/2012
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 2061 PEACHTREE RD NE STE 500
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City | ATLANTA
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State | GA
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Zip | 30309-1446
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Country | US
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Telephone | 404-352-3522
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Fax | 404-352-9251
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Provider Business Mailing Address
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Address Line | 2061 PEACHTREE RD NE STE 500
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City | ATLANTA
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State | GA
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Zip | 30309-1446
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Country | US
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Telephone | 404-352-3522
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Fax | 404-352-9251
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207XS0106X
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Taxonomy Name | Orthopaedic Hand Surgery Physician
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License Number | 080980
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License Number State | GA
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