Individual
DR. BRYAN T HEAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 CLUB LN STE 1, CONWAY, AR 72034-3681
(501) 329-1510
(501) 329-5697
Mailing address
PO BOX 9662, CONWAY, AR 72033-9662
(501) 852-1363
(501) 852-1364
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
BP10057608
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BP10057608
PIT PERMIT
TX
Enumeration date
06/02/2016
Last updated
04/24/2023
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