Provider Demographics
NPI:1386050060
Name:O'BRYANT, STEVEN (DPM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:O'BRYANT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:955 N MCQUEEN RD STE 1
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8129
Mailing Address - Country:US
Mailing Address - Phone:480-744-6234
Mailing Address - Fax:480-907-0500
Practice Address - Street 1:955 N MCQUEEN RD STE 1
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8129
Practice Address - Country:US
Practice Address - Phone:480-744-6234
Practice Address - Fax:480-907-0500
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ868213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery