Provider Demographics
NPI:1184990798
Name:BRYANT, DANIEL NATHAN (PHARMD)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:NATHAN
Last Name:BRYANT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3171 HIGHWAY 8
Mailing Address - Street 2:
Mailing Address - City:NEW EDINBURG
Mailing Address - State:AR
Mailing Address - Zip Code:71660-8275
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:908 WEST 4TH ST
Practice Address - Street 2:WATSON PHARMACY
Practice Address - City:FORDYCE
Practice Address - State:AR
Practice Address - Zip Code:71742-2216
Practice Address - Country:US
Practice Address - Phone:870-352-2161
Practice Address - Fax:870-352-3236
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-28
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD09866183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist