Provider Demographics
NPI:1912264755
Name:SIRMON, BRYAN JOEL (MD)
Entity Type:Individual
Prefix:MR
First Name:BRYAN
Middle Name:JOEL
Last Name:SIRMON
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 1:2061 PEACHTREE RD NE STE 500
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1446
Mailing Address - Country:US
Mailing Address - Phone:404-352-3522
Mailing Address - Fax:404-352-9251
Practice Address - Street 1:2061 PEACHTREE RD NE STE 500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1446
Practice Address - Country:US
Practice Address - Phone:404-352-3522
Practice Address - Fax:404-352-9251
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GA080980207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program