Individual
DR. BRIAN TRISSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1900 TEBEAU ST, WAYCROSS, GA 31501-6357
(912) 283-3030
Mailing address
83245 PURPLE MARTIN DR, YULEE, FL 32097-2628
(571) 296-5110
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-48039
KS
2085R0202X
Diagnostic Radiology Physician
2018009816
MO
2085R0202X
Diagnostic Radiology Physician
Primary
88597
GA
2085R0202X
Diagnostic Radiology Physician
ME149470
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
004030032
PTAN
KS
05
—
10030307600
—
NE
05
—
30004976670001
—
KS
Enumeration date
04/10/2016
Last updated
03/20/2026
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