Provider Demographics
NPI:1245296391
Name:PRYBIS, BRAD (MD)
Entity type:Individual
Prefix:DR
First Name:BRAD
Middle Name:
Last Name:PRYBIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 HOUZE WAY STE A1
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1432
Mailing Address - Country:US
Mailing Address - Phone:404-913-7707
Mailing Address - Fax:855-430-0764
Practice Address - Street 1:600 HOUZE WAY STE A1
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1432
Practice Address - Country:US
Practice Address - Phone:404-913-7707
Practice Address - Fax:855-430-0764
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2025-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA054427207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA304588125AMedicaid
GAH82583Medicare UPIN
GA304588125AMedicaid