Provider Demographics
NPI:1215138375
Name:BRYANT, CARYN (MD)
Entity type:Individual
Prefix:DR
First Name:CARYN
Middle Name:
Last Name:BRYANT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 E HARRY ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-3713
Mailing Address - Country:US
Mailing Address - Phone:316-796-7990
Mailing Address - Fax:316-796-7999
Practice Address - Street 1:3600 E HARRY ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-3713
Practice Address - Country:US
Practice Address - Phone:316-796-7990
Practice Address - Fax:316-796-7999
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-33359207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS111391019OtherMEDICARE
KS200584660CMedicaid
KS200584660AMedicaid
KS111391019OtherMEDICARE
KS016576027Medicare PIN