Individual
DR. JOSEPH SHEPARD BRYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7600 N 15TH ST, SUITE 155, PHOENIX, AZ 85020-4327
(602) 242-4928
(602) 249-4813
Mailing address
7600 N 15TH ST, SUITE 155, PHOENIX, AZ 85020-4327
(602) 242-4928
(602) 249-4813
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
23580
AZ
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
23580
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18WCKDW04
MEDICARE PART B
AZ
05
—
325127
—
AZ
Enumeration date
08/18/2005
Last updated
04/04/2017
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