MEDICARE: BRETT BRYANT 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	OPT003022	GA
2	152W00000X	Optometrist	R-343-TA-D31	AL

General Provider Information

NPI Number	:	1891225066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRETT BRYANT OD

Provider Business Mailing Address
First Line	:	10 POLARIS CIR
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35215-7016
Country	:	US
Telephone Number	:	205-229-3965
Fax Number	:

Provider Business Practice Location Address
First Line	:	1755 HIGHWAY 77
Second Line	:
City	:	SOUTHSIDE
State	:	AL
Zip	:	35907-0169
Country	:	US
Telephone Number	:	256-442-6200
Fax Number	:

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

Provider Enumeration Date	:	06/19/2017
Last Update Date	:	02/05/2025

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Directions to “ BRETT BRYANT OD” Practice Location

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