Individual
MRS. MARY BAILEY WICKHAM BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2300 MANCHESTER EXPY STE A005, COLUMBUS, GA 31904-6805
(706) 322-6646
(706) 322-2891
Mailing address
2300 MANCHESTER EXPY STE 2001A, COLUMBUS, GA 31904-6802
(706) 320-3126
(706) 320-3054
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008723
GA
Other
Enumeration date
10/06/2016
Last updated
07/29/2024
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