| Clinton Ray Brunson, MD | |
|
2900 S Loop 256, Palestine, TX 75801-6958 | |
| (903) 731-1084 | |
| Not Available |
| Full Name | Clinton Ray Brunson |
|---|---|
| Gender | Male |
| Speciality | Diagnostic Radiology |
| Experience | 34 Years |
| Location | 2900 S Loop 256, Palestine, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942252267 | NPI | - | NPPES |
| 045395301 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | L0054 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Saint Thomas West Hospital | Nashville, TN | Hospital |
| St John Medical Center, Inc | Tulsa, OK | Hospital |
| Research Medical Center | Kansas city, MO | Hospital |
| Saint Thomas Rutherford Hospital | Murfreesboro, TN | Hospital |
| North Texas Medical Center | Gainesville, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Concord Radiology Pllc | 8628332061 | 196 |
| Coaxion Pllc | 3779099643 | 30 |
| Peterson Medical Associates | 1355467887 | 191 |
| Entity Name | Clinton Ray Brunson, Md, Pa |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1730695214 PECOS PAC ID: 0547525750 Enrollment ID: O20180517000555 |
| Mailing Address | Practice Location Address |
|---|---|
| Clinton Ray Brunson, MD 4777 Us Highway 259, Longview, TX 75605-7668 Ph: (903) 663-4800 | Clinton Ray Brunson, MD 2900 S Loop 256, Palestine, TX 75801-6958 Ph: (903) 731-1084 |
Dr. James Franklin Wilder Jr., MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 3415 S Loop 256, Palestine, TX 75801 Phone: 903-727-2200 Fax: 903-727-2209 | |
Lauren Martinez, MD Radiology Medicare: Accepting Medicare Assignments Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 424-290-8004 | |
Gary M Waddell, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2900 S Loop 256, Palestine, TX 75801 Phone: 903-731-1084 |