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TIMOTHY C. BRYAN MD PLC NPI 1124224126


NPI Information

NPI: 1124224126
Provider Name: TIMOTHY C. BRYAN, MD, PLC

Doing Business As: GATEWAY FAMILY MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 03D2006149

Address:
4365 E PECOS RD
SUITE 134
GILBERT, AZ
ZIP 85295
Phone: (480) 840-9155
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TIMOTHY C. BRYAN, MD, PLC is a family medicine in Gilbert, AZ. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. TIMOTHY C. BRYAN, MD, PLC NPI is 1124224126. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Gateway Family Medicine.

The provider's business location address is:

4365 E PECOS RD
SUITE 134
GILBERT, AZ
ZIP 85295-053
Phone: (480) 840-9155
Fax: (480) 840-9320

The provider's authorized official is Timothy C Bryan .
The authorized official title is Owner Manager and has the following contact phone number (480) 840-9155.

The CLIA number assigned to this NPI record is 03D2006149 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/26/2007 and was last updated on 12/22/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine35487ARIZONAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1112422412MEDICARE UPINARIZONA
2Z115922MEDICARE PINARIZONA
3104591MEDICAIDARIZONA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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