Dr James Witt Bryan Iv, MD is a medicare enrolled "Family Medicine - Sports Medicine" physician in Little Rock Air Force Base, Arkansas. His current practice location is
1090 Arnold Dr, 19 Amds/sgpf, Little Rock Air Force Base, Arkansas. You can reach out to his office (for appointments etc.) via phone at
(501) 987-7319.
Dr James Witt Bryan Iv is licensed to practice in Arkansas (license number C-7904) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1558326454.
Physician's Profile
| Full Name | Dr James Witt Bryan Iv |
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| Gender | Male |
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| Speciality | Family Medicine - Sports Medicine |
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| Location | 1090 Arnold Dr, Little Rock Air Force Base, Arkansas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1558326454
- Provider Enumeration Date: 04/20/2006
- Last Update Date: 03/11/2024
Medicare PECOS Information:
- PECOS PAC ID: 1456426188
- Enrollment ID: I20080814000753
Medical Identifiers
Medical identifiers for Dr James Witt Bryan Iv such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1558326454 | NPI | - | NPPES |
| 121472001 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207QS0010X | Family Medicine - Sports Medicine | C-7904 (Arkansas) | Primary |
| 207Q00000X | Family Medicine | C-7904 (Arkansas) | Secondary |
| 207Q00000X | Family Medicine | C7904 (Arkansas) | Secondary |
| 207QS0010X | Family Medicine - Sports Medicine | C7904 (Arkansas) | Secondary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr James Witt Bryan Iv allows following entities to bill medicare on his behalf.
| Entity Name | University Of Arkansas For Medical Sciences |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1588654016
PECOS PAC ID: 4082528955
Enrollment ID: O20031219000706 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr James Witt Bryan Iv is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr James Witt Bryan Iv, MD
1090 Arnold Dr,
Little Rock Air Force Base, AR 72099-4933
Ph: (501) 987-7319 | Dr James Witt Bryan Iv, MD
1090 Arnold Dr, 19 Amds/sgpf,
Little Rock Air Force Base, AR 72099-4933
Ph: (501) 987-7319 |
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