Individual
HENRY GREENE BRYANT III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2030 WALTON WAY, AUGUSTA, GA 30904-4120
(706) 738-1925
(706) 738-0705
Mailing address
4321 UNIVERSITY PKWY, BLDG 2 SUITE 103, EVANS, GA 30809-3093
(706) 738-1925
(706) 738-0705
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POD000710
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00232658C
—
GA
01
—
3839091
MEDICARE NSC
GA
01
—
480026650
RAILROAD MEDICARE
GA
01
—
48SCBZR
MEDICARE
GA
01
—
52473102
BLUE CROSS BLUE SHIELD
GA
Enumeration date
04/20/2006
Last updated
07/24/2015
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