Individual
DR. JESSE THORNTON BRYANT IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2409 RING RD STE 114, ELIZABETHTOWN, KY 42701-5935
(270) 982-3344
(270) 982-3366
Mailing address
2409 RING RD STE 114, ELIZABETHTOWN, KY 42701-5935
(270) 982-3344
(270) 982-3366
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
31987
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64036585
—
KY
Enumeration date
07/12/2006
Last updated
02/28/2008
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