| 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 | ME175252 (Florida) | Secondary |
| 2085R0202X | Radiology - Diagnostic Radiology | L0054 (Texas) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Ascension Saint Thomas Hospital | Nashville, TN | Hospital |
| Ascension St John Medical Center | Tulsa, OK | Hospital |
| Research Medical Center | Kansas city, MO | Hospital |
| Ascension Saint Thomas Rutherford Hospital | Murfreesboro, TN | Hospital |
| Decatur Morgan Hospital-decatur Campus | Decatur, AL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Concord Radiology Pllc | 8628332061 | 217 |
| Coaxion Pllc | 3779099643 | 31 |
| Peterson Medical Associates | 1355467887 | 192 |
| Entity Name | Peterson Medical Associates |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1770800575 PECOS PAC ID: 1355467887 Enrollment ID: O20100922000142 |
| Entity Name | Concord Radiology PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598260515 PECOS PAC ID: 8628332061 Enrollment ID: O20180510001179 |
| 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 |
| Entity Name | Coaxion PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629805221 PECOS PAC ID: 3779099643 Enrollment ID: O20250718001884 |
| 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 |