Provider Demographics
NPI:1740422633
Name:BRYSON, ROBERT S (PA-C)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:S
Last Name:BRYSON
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Gender:M
Credentials:PA-C
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Mailing Address - Street 1:CHARLES LUKE MILAM CLINIC
Mailing Address - Street 2:BLDG RR440 PSC BOX 20117
Mailing Address - City:CAMP LEJEUNE
Mailing Address - State:NC
Mailing Address - Zip Code:28542-0117
Mailing Address - Country:US
Mailing Address - Phone:910-440-0230
Mailing Address - Fax:910-440-1326
Practice Address - Street 1:CHARLES LUKE MILAM CLINIC
Practice Address - Street 2:BLDG RR440
Practice Address - City:CAMP LEJEUNE
Practice Address - State:NC
Practice Address - Zip Code:28542-0117
Practice Address - Country:US
Practice Address - Phone:910-440-0230
Practice Address - Fax:910-440-1326
Is Sole Proprietor?:No
Enumeration Date:2009-03-24
Last Update Date:2022-04-27
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0010-10842OtherNCMB LICENSURE