NPI 1194995696

Edwin D Bryan INC

Organisation Preferred Provider Organization Bay Minette, AL

Practice location

Address: 701 McMeans Ave, Bay Minette, AL 36507-3337
Phone: (251) 937-1397
Mailing address: 12930 Mary Ann Beach Rd, Fairhope, AL 36532-5423

Authorised official

Name: Edwin D Bryan
Title: Optometrist
Phone: (251) 929-3191

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence S-490-TA-140 (AL)

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Registry record

NPI: 1194995696
Entity type: Organization
NPI issued: 11 Mar 2008
Record last updated: 3 Apr 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.