Individual
DR. JILL G BRYANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
711 KNIGHT AVE, WAYCROSS, GA 31501-1943
(912) 283-9423
(912) 283-8204
Mailing address
711 KNIGHT AVE, WAYCROSS, GA 31501-1943
(912) 283-9423
(912) 283-8204
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
043375
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000755125D
—
GA
01
—
1306820741
MEDICARE NPI
GA
01
—
CG6045
RAILROAD MEDICARE GROUP ID
GA
Enumeration date
11/30/2005
Last updated
11/17/2020
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