Individual
DR. JAMES WITT BRYAN IV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1090 ARNOLD DR, 19 AMDS/SGPF, LITTLE ROCK AIR FORCE BASE, AR 72099-4933
(501) 987-7319
(501) 987-1464
Mailing address
1090 ARNOLD DR, LITTLE ROCK AIR FORCE BASE, AR 72099-4933
(501) 987-7319
(501) 987-1464
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
C-7904
AR
207Q00000X
Family Medicine Physician
C7904
AR
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
C-7904
AR
207QS0010X
Sports Medicine (Family Medicine) Physician
C7904
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
121472001
—
AR
Enumeration date
04/20/2006
Last updated
03/11/2024
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