Individual
JOHNNY WAYNE BRYANT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
423 SOUTH 28TH ST, SUITE A, PADUCAH, KY 42003-3865
(270) 442-7181
(271) 442-0113
Mailing address
423 SOUTH 28TH ST, SUITE A, PADUCAH, KY 42003-3865
(270) 442-7181
(271) 442-0113
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
35692
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64013931
—
KY
Enumeration date
04/04/2006
Last updated
06/20/2012
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