Michael Anthony Bryant, PA-C
Physician Assistant in Carbondale, IL. Individual provider (NPI-1).
NPI number1871542811
StatusActive
Last updated in NPPESAug 14, 2023
Details
- NPI
- 1871542811
- Entity type
- Individual (NPI-1)
- Name
- Michael Anthony Bryant
- Credential
- PA-C
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- May 8, 2006
- Certification date
- Aug 14, 2023
- Last updated
- Aug 14, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 085002238 | IL | Yes |
| 363AS0400X | Physician Assistant, Surgical | 2005019359 | MO | |
| 363AS0400X | Physician Assistant, Surgical | 2162 | TN |
Practice location
305 W Jackson St Ste 400Carbondale, IL 62901-1474
Phone 618-351-4972 · Fax 618-351-4973
Mailing address
Po Box 3988Carbondale, IL 62902-3988
Phone 618-457-5200
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All 68 Physician Assistant providers in Carbondale · All 1,335 providers in Carbondale
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