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General NPI Number Information
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NPI Number | 1992157085
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Entity Type | Individual
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Provider Name | JIMMY BRYANT AUSTIN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 12/19/2022
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Provider Practice Location Address
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Address Line | 25 PEACHTREE ST SW
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City | ATLANTA
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State | GA
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Zip | 30303-3140
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Country | US
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Telephone | 404-260-1038
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Fax | 404-260-1039
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Provider Business Mailing Address
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Address Line | 565 PEACHTREE ST NE STE B
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City | ATLANTA
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State | GA
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Zip | 30308-2213
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Country | US
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Telephone | 404-662-3433
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Fax | 404-662-3435
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH028494
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License Number State | GA
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