Provider Demographics
NPI:1457537938
Name:WASHINGTON G. B. BRYAN LTD
Entity Type:Organization
Organization Name:WASHINGTON G. B. BRYAN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:WASHINGTON
Authorized Official - Middle Name:G B
Authorized Official - Last Name:BRYAN
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:504-891-3711
Mailing Address - Street 1:3720 PRYTANIA ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70115-3733
Mailing Address - Country:US
Mailing Address - Phone:504-891-3711
Mailing Address - Fax:504-891-6353
Practice Address - Street 1:3720 PRYTANIA ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70115-3733
Practice Address - Country:US
Practice Address - Phone:504-891-3711
Practice Address - Fax:504-891-6353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2011-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAMD.05226R207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
5CA66Medicare PIN