Provider Demographics
NPI:1609871136
Name:BRYA, MARGARET S (OD)
Entity Type:Individual
Prefix:DR
First Name:MARGARET
Middle Name:S
Last Name:BRYA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:MEG
Other - Middle Name:S
Other - Last Name:BRYA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:698 S MILLEDGE AVE
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30605-1251
Mailing Address - Country:US
Mailing Address - Phone:706-543-2020
Mailing Address - Fax:706-549-6618
Practice Address - Street 1:698 S MILLEDGE AVE
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30605-1251
Practice Address - Country:US
Practice Address - Phone:706-543-2020
Practice Address - Fax:706-549-6618
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002101152W00000X, 152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA703133OtherBCBS
GA713174245AMedicaid
GA582102247OtherCOMMERCIAL
GA582102247OtherCOMMERCIAL
GA41ZCFKZMedicare ID - Type Unspecified