Individual
DR. BRYAN DAVID LEATHERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1213 BROAD AVE, SUITE 4, GULFPORT, MS 39501-2475
(228) 864-2121
Mailing address
218 OAKWOOD DR, GULFPORT, MS 39507-1918
(228) 896-2896
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
17564
MS
207YX0602X
Otolaryngic Allergy Physician
Primary
17564
MS
Other
Enumeration date
06/21/2006
Last updated
09/11/2025
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