Provider Demographics
NPI:1457739286
Name:BRYANT, ZACHARY JAMES (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:JAMES
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:PO BOX 6599
Mailing Address - Street 2:
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36302-6599
Mailing Address - Country:US
Mailing Address - Phone:334-699-7900
Mailing Address - Fax:
Practice Address - Street 1:4300 W MAIN ST STE 21
Practice Address - Street 2:
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1058
Practice Address - Country:US
Practice Address - Phone:334-699-7900
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-13
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN66129208600000X
AL47733208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery