NPIMap

Organization Active NPI

West Memphis Eye Center, PA

Doing business as Glen Edward Bryant jr.

  • Ophthalmology Physician
  • West Memphis, AR
National Provider Identifier
1205860459
Registry record updated Dec 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WEST MEMPHIS EYE CENTER, PA
Doing business as
Glen Edward Bryant jr.
Practice address
303 W Polk
Suite a
West Memphis, AR 72301
Phone
(870) 732-2100
Fax
(870) 732-3027
NPI assigned
Jul 11, 2006
Last updated
Dec 12, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2013

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

Authorized official

Name
Dr. Glen Edward Bryant II, M.D.
Title
Owner
Phone
(870) 732-2100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X Primary

Addresses

Primary practice location

303 W Polk
Suite a
West Memphis, AR 72301

Mailing address

303 W Polk
Suite a
West Memphis, AR 72301
Phone (870) 732-2100

Other identifiers 2

IdentifierTypeStateIssuer
102003001MedicaidAR
111786002MedicaidAR

Other names 1

  • Glen Edward Bryant jr. Doing business as

National Provider Directory

National Provider Directory

Locations

330 Dillard St
Forrest City, AR 72335
Phone (870) 633-1174

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386806400000",
    "number": "1205860459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 W POLK",
            "address_2": "SUITE A",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-732-2100",
            "fax_number": "870-732-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 W POLK",
            "address_2": "SUITE A",
            "city": "WEST MEMPHIS",
            "state": "AR",
            "postal_code": "72301",
            "telephone_number": "870-732-2100",
            "fax_number": "870-732-3027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST MEMPHIS EYE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2013-12-12",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "GLEN",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "870-732-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "102003001",
            "state": "AR"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "111786002",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Edward Bryant jr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Memphis, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2013; 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.