Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Individual
DR. JACK WADE BRUNSON JR.
Active
Individual
DR. JACK WADE BRUNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
10099
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100991
—
SC
01
—
SCI6605019
MEDICARE PIN
SC
01
—
SCI6606067
MEDICARE PIN
SC
Enumeration date
01/30/2006
Last updated
12/08/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up