Michael Bryant Jr.
Individual provider Active NPI Pharmacist · Newport, AR
NPI 1093315541 · NPPES record last updated Oct 26, 2020
Key facts
- NPI
- 1093315541
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PD13704 (AR)
- Practice address
- 1211 Highway 367 N
Newport, AR 72112-2513 - Phone
- (870) 523-2383
- NPI assigned
- Oct 26, 2020
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PD13704 | AR | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past |
Accepting new patients | |
| Walmart Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PD13704 | AR | Yes |
Addresses
Primary practice location
1211 Highway 367 N
Newport, AR 72112-2513
Mailing address
1211 Highway 367 N
Newport, AR 72112-2513
Phone (870) 523-2383
Other providers in Newport, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 26, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.