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Individual

DR. LADONNA J BRYAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1600 W WALNUT ST, PASSAVANT SURGICAL ASSOCIATES, JACKSONVILLE, IL 62650-1136
(217) 479-5821
(217) 243-7406
Mailing address
1600 W WALNUT ST, PASSAVANT SURGICAL ASSOCIATES, JACKSONVILLE, IL 62650-1136
(217) 479-5821
(217) 243-7406

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036111023 1
IL
05
036111023 2
IL
Enumeration date
08/29/2006
Last updated
03/07/2023
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