Organization
BRYANT FAMILY MEDICAL CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GAELLE BRYANT (BUSINESS MANAGER)
(501) 804-9712
Entity
Organization
Contact information
Practice address
408 OFFICE PARK DR STE 3, BRYANT, AR 72022-7536
(501) 847-2835
(501) 847-6809
Mailing address
408 OFFICE PARK DR STE 3, BRYANT, AR 72022-7536
(501) 847-2835
(501) 847-6809
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
MC2196
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MC2196
ARKANSAS STATE MEDICAL BO
AR
Enumeration date
02/28/2007
Last updated
07/24/2019
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