Individual
MR. TIMOTHY A. BRYAN SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5665 NEW NORTHSIDE DR NW, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-6844
Mailing address
5665 NEW NORTHSIDE DR NW, SUITE 320, ATLANTA, GA 30328-5831
(770) 874-6844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2994-23
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100043936
—
WI
Enumeration date
09/14/2012
Last updated
04/14/2020
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