Individual
DR. JACK BRIDGES
Active
Individual
DR. JACK BRIDGES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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