Bryan D Fuller MD PA

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

Legal business name

BRYAN D FULLER MD PA

Practice address

625 United Dr Ste 330
Conway, AR 72032-7828

Phone

(501) 748-8450

Fax

(501) 379-8428

NPI assigned

Jul 27, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jennifer Smith

Title

Administrator

Phone

(501) 748-8450

Specialties & licenses 1

Addresses

Other names 1

• Natural State OBGYN Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657238400000",
    "number": "1184233173",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 UNITED DR STE 330",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327828",
            "telephone_number": "501-748-8450",
            "fax_number": "501-379-8428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 UNITED DR STE 330",
            "city": "CONWAY",
            "state": "AR",
            "postal_code": "720327828",
            "telephone_number": "501-748-8450",
            "fax_number": "501-379-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN D FULLER MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2022-07-08",
        "certification_date": "2022-07-08",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "501-748-8450"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Natural State OBGYN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Natural State OBGYN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Natalie Claire Brownd, APRN
• Amy D Broyles, APRN
• Sarah Elizabeth Broyles, PT, DPT
• Lacie Deann Bruick, MSCCCSLP
• Bryan Brown, OD LLC
• Brittney Bryan, PT, DPT
• Haley Michelle Bryant, APRN
• Joe Nathan Bryant IV, MHPP
• Kelly Bryant, RECOVERY ASSISTANT
• Kevin Bryant

• Obstetrics & Gynecology Physician in Conway, AR
• Providers in Conway, AR by specialty
• Obstetrics & Gynecology Physician in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.