Bryan, Ladonna J

Bryan, Ladonna J is an individual health care provider with primary practice located at 1600 W Walnut St Passavant Surgical Associates, Jacksonville IL 62650-1136. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Bryan, Ladonna J can be contacted via phone (217) 479-5821.

Contact Information

Primary practice address
1600 W Walnut St Passavant Surgical Associates Jacksonville IL 62650-1136
Phone: (217) 479-5821
Fax: (217) 243-7406
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X Illinois

Profile Details

NPI number 1508975285
LBN Legal business name Bryan, Ladonna J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508975285 NPPES
Illinois MEDICAID 036111023 1
Illinois MEDICAID 036111023 2

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