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Contact Information

JUSTIN R BRYANT, DO, MBA
11141 PARKVIEW PLAZA DR STE 300
FORT WAYNE, IN46845-1715
 Phone: 260-425-6960
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Plastic Surgery

208200000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JUSTIN R BRYANT · (Male)

NPI # 1427363449
Status Active
Credentials DO, MBA
Entity Individual
Enumeration date 08/13/2010
Last updated 05/22/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • DC License # DO034726
  • FL License # OS21663
  • IN License # 02004908A
  • WI License # 71983
  • WI Medicaid 1427363449
Hospital affiliation(s)
  • PARKVIEW REGIONAL MEDICAL CENTER - (Acute Care)
    11109 PARKVIEW PLAZA DRIVE
    FORT WAYNE, IN 46845
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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