Provider Demographics
NPI:1013954817
Name:D'ORSAY D. BRYANT, III, MD, PA
Entity Type:Organization
Organization Name:D'ORSAY D. BRYANT, III, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:D'ORSAY
Authorized Official - Middle Name:D
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:870-289-5865
Mailing Address - Street 1:PO BOX 295
Mailing Address - Street 2:
Mailing Address - City:LOCKESBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71846-0295
Mailing Address - Country:US
Mailing Address - Phone:870-289-5865
Mailing Address - Fax:870-289-6993
Practice Address - Street 1:619 THOMPSON AVE
Practice Address - Street 2:
Practice Address - City:EL DORADO
Practice Address - State:AR
Practice Address - Zip Code:71730-4557
Practice Address - Country:US
Practice Address - Phone:870-863-3122
Practice Address - Fax:870-863-9377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-01
Last Update Date:2010-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR136066002Medicaid
AR0523760001Medicare NSC