Clinton Ray Brunson, MD PA

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

CLINTON RAY BRUNSON, MD PA

Practice address

3206 4TH St
Longview, TX 75605-5143

Phone

(903) 663-4800

Fax

(903) 663-7394

NPI assigned

Dec 20, 2017

Last updated

Dec 20, 2017By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Clinton Ray Brunson, MDNPI 1942252267

Title

President

Phone

(903) 316-8442

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Clinton Ray Brunson, M.D.

  • Diagnostic Radiology Physician
  • Palestine, TX
  • NPI 1942252267
  Medicare reassignment Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513728000000",
    "number": "1730695214",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3206 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055143",
            "telephone_number": "903-663-4800",
            "fax_number": "903-663-7394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3206 4TH ST",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756055143",
            "telephone_number": "903-663-4800",
            "fax_number": "903-663-7394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON RAY BRUNSON, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "last_updated": "2017-12-20",
        "status": "A",
        "authorized_official_last_name": "BRUNSON",
        "authorized_official_first_name": "CLINTON",
        "authorized_official_middle_name": "RAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-316-8442",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Cleary, LCDC
• Karin Clements, LCSW
• Tiffany Gayla Clendening, PMHNP
• Mark Clifton
• Clinnard LLC
• Angela Clipperton, RN
• George H Cloud Jr., DDS
• Kimberly Clough, LCSW
• Christy Anne Cobb, FNP-C
• Codreaming LLC (The Body Mechanics)

• Diagnostic Radiology Physician in Longview, TX
• Providers in Longview, TX by specialty
• Diagnostic Radiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.