Individual
DR. JACK WADE BRUNSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
398 THE PKWY, GREER, SC 29650-4569
(864) 877-9577
(864) 877-9073
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
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.
Contact us