Individual
DR. JACK BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6575
(816) 271-6139
Mailing address
3906 OAKLAND AVE UNIT 8252, SAINT JOSEPH, MO 64508-7515
(816) 271-7648
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0427939
KS
2085R0202X
Diagnostic Radiology Physician
Primary
102182
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100287240B
—
KS
01
—
106183
BCBS KS FOR KS LOCATION
KS
05
—
203612924
—
MO
01
—
24064048
BCBS OF KC MO
MO
01
—
300138251
RR MEDICARE GROUP CK7871
MO
01
—
403000007
PTAN
KS
01
—
470767
BCBS KS FOR MO LOCATION
—
Enumeration date
02/20/2006
Last updated
03/02/2026
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