Provider Demographics
NPI:1891108825
Name:THORSEN, BRYAN (OD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:
Last Name:THORSEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 OGEECHEE RD
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31419-9544
Mailing Address - Country:US
Mailing Address - Phone:912-806-0004
Mailing Address - Fax:912-480-6050
Practice Address - Street 1:6000 OGEECHEE RD
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31419-9544
Practice Address - Country:US
Practice Address - Phone:912-480-6000
Practice Address - Fax:912-480-6050
Is Sole Proprietor?:No
Enumeration Date:2014-06-06
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT002850152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist