Individual
OTIS HENDON BRUNSON IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-5604
(601) 984-6665
Mailing address
1500 E WOODROW WILSON AVE, JACKSON, MS 39216-5116
(601) 362-4471
(601) 364-1344
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
28981
MS
207RX0202X
Medical Oncology Physician
Primary
28981
MS
Other
Enumeration date
04/20/2018
Last updated
05/05/2025
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