Bryant, Mark L

Bryant, Mark L is an individual health care provider with primary practice located at 1011 N 4Th St , Cordele GA 31015. He recently has only one registered license in Eye and Vision Services Providers / Occupational Vision, which is considered as his primary health care specialty. Bryant, Mark L can be contacted via phone (229) 273-0435.

Contact Information

Primary practice address
1011 N 4Th St Cordele GA 31015
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Occupational Vision 152WX0102X 001209 Georgia

Profile Details

NPI number 1508860099
LBN Legal business name Bryant, Mark L
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 13th, 2005
Last updated Jun 13th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508860099 NPPES
Georgia Other 483070 AETNA
Georgia Other 410048938 AETNA
Georgia MEDICAID 00415269A AETNA
Georgia Other 538385 AETNA

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