Provider Demographics
NPI:1346328556
Name:BRYANT, JOHN F (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:BRYANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2301 HOUSE AVE STE 502
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82001-3179
Mailing Address - Country:US
Mailing Address - Phone:307-635-4131
Mailing Address - Fax:307-635-4134
Practice Address - Street 1:2301 HOUSE AVE STE 502
Practice Address - Street 2:
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82001-3179
Practice Address - Country:US
Practice Address - Phone:307-635-4131
Practice Address - Fax:307-635-4134
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY6656A208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY117112700Medicaid
WY311378OtherBLUE CROSS BLUE SHIELD OF WYOMING
WY340020255OtherRAILROAD MEDICARE
WY311378OtherBLUE CROSS BLUE SHIELD OF WYOMING
WY340020255OtherRAILROAD MEDICARE