MEDICARE: DR. MARGARET S. BRYA OD

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	152W00000X	Optometrist	OPT002101	GA
2	152WV0400X	Vision Therapy Optometrist	OPT002101	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	703133	OTHER	GA	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	582102247	OTHER	GA	COMMERCIAL

General Provider Information

NPI Number	:	1609871136
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGARET S. BRYA OD

Provider Business Mailing Address
First Line	:	698 S MILLEDGE AVE
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30605-1251
Country	:	US
Telephone Number	:	706-543-2020
Fax Number	:	706-549-6618

Provider Business Practice Location Address
First Line	:	698 S MILLEDGE AVE
Second Line	:
City	:	ATHENS
State	:	GA
Zip	:	30605-1251
Country	:	US
Telephone Number	:	706-543-2020
Fax Number	:	706-549-6618

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	08/11/2010

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