Provider Demographics
NPI:1760011019
Name:BRYANT, DOUGLAS GEORGE (MD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:GEORGE
Last Name:BRYANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 CHILDRENS WAY STE 1221
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-3164
Mailing Address - Country:US
Mailing Address - Phone:615-322-0738
Mailing Address - Fax:
Practice Address - Street 1:2201 CHILDRENS WAY STE 1221
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-3164
Practice Address - Country:US
Practice Address - Phone:615-322-0738
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-07
Last Update Date:2020-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program