MEDICARE: JONATHAN D BRYANT DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician	0102206422	VA
2	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	4596	TN

General Provider Information

NPI Number	:	1407203755
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JONATHAN D BRYANT DO

Provider Business Mailing Address
First Line	:	340 STEELES RD
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-9532
Country	:	US
Telephone Number	:	423-282-9011
Fax Number	:	423-282-0035

Provider Business Practice Location Address
First Line	:	340 STEELES RD
Second Line	:
City	:	BRISTOL
State	:	TN
Zip	:	37620-9532
Country	:	US
Telephone Number	:	423-282-9011
Fax Number	:	423-282-0035

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/17/2016
Last Update Date	:	03/16/2026

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