Individual
LIONEL BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1007 MARY ST, WAYCROSS, GA 31503-3823
(912) 449-7100
Mailing address
1007 MARY ST, WAYCROSS, GA 31503-3823
(912) 449-7100
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
022725
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003122616A
—
GA
Enumeration date
01/30/2007
Last updated
04/30/2012
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