Provider Demographics
NPI:1336124379
Name:BRYANT, PATY BARGERON (MD)
Entity Type:Individual
Prefix:
First Name:PATY
Middle Name:BARGERON
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 7TH AVE S
Mailing Address - Street 2:SUITE 420 ACC
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1711
Mailing Address - Country:US
Mailing Address - Phone:205-939-9235
Mailing Address - Fax:205-939-9936
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:SUITE 420 ACC
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9235
Practice Address - Fax:205-939-9936
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12709207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051083228OtherBLUE CROSS BLUE SHIELD
AL00083228Medicaid
AL051083228OtherBLUE CROSS BLUE SHIELD
AL000083228Medicare PIN