CLINTON RAY BRUNSON, MD PA (NPI# 1730695214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730695214 |
| Entity Type | Organization |
| Organization Name | CLINTON RAY BRUNSON, MD PA |
| Practice Address |
3206 4th St Longview TX 75605-5143 |
| Practice Telephone | 9036634800 |
| Practice Fax Number | 9036637394 |
| Mailing Telephone | 9036634800 |
| Mailing Fax Number | 9036637394 |
| Enumeration Date | 2017-12-20 |
| Last Update Date | 2017-12-20 |
| Authorized Official Name | CLINTON RAY BRUNSON (PRESIDENT) |
| Authorized Official Telephone | 9033168442 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| Street Address |
3206 4TH ST |
| City | LONGVIEW |
| State | TX |
| Zip Code | 75605-5143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194353730 | Dusty Rae Hane | Nurse Practitioner | Diagnostic Clinic of Longview, 2901 N Fourth St, Longview, TX 75605 | 2020-03-30 |
| 1831720374 | Kaycee Whatley | Nurse Practitioner | 323 W Hawkins Parkway, Longview, TX 75605 | 2020-02-03 |
| 1245733492 | Somers Pediatrics | Pediatrics | 103 W. Loop 281, Suite 474, Longview, TX 75605 | 2018-03-14 |
| 1467838391 | Piney Woods Er II LLC | Clinic/Center | 120 East Loop 281, Longview, TX 75605 | 2015-08-03 |
| 1386023968 | Elizabeth Ann Heeb Tidwell | Obstetrics & Gynecology | 802 Medical Dr Ste 100, Longview, TX 75605 | 2015-05-28 |
| 1215353651 | Tracy Hicks | Nurse Practitioner | 102 Commander Dr Ste 9, Longview, TX 75605 | 2014-03-10 |
| 1073881280 | Deirdre Scotter | Specialist/Technologist | 201 E Tomlinson Pkwy, Longview, TX 75605 | 2011-12-02 |
| 1316230139 | Traditions Hospice of Longview, LLC | Hospice Care, Community Based | 4362 N Us Hwy 259, Suite B, Longview, TX 75605 | 2011-05-26 |
| 1184916769 | Telema Dikibujiri Nga | Pediatrics | Longview Regional Medical Center, 2901 North Fourth Street, Longview, TX 75605 | 2011-05-13 |
| 1902101108 | The Veta Lewis Behavioral Health Group | Counselor | 1800 S. Judson St., Suite 100, Longview, TX 75605 | 2011-01-19 |
| Find all providers in zip 75605 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205861895 | Longview Diagnostic Imaging, Ltd | Radiology | 1010 N 6th St, Longview, TX 75601-5534 | 2006-07-11 |
| 1316992720 | Open Advanced Mri Longview LLC | Radiology | 1015 Ocean Beach Hwy, #125, Longview, WA 98632-4098 | 2006-05-23 |
| 1447208103 | Venous Laser Center of East Texas | Radiology | 903 N 4th St, Longview, TX 75601-5416 | 2006-05-05 |
| 1295725158 | Radames Martinez Jr. | Radiology | 3713 Holly Trl, Longview, TX 75605-2541 | 2005-10-24 |
| 1114920444 | John Richardson Wilcox Jr. | Radiology | 4777 Us Highway 259, Longview, TX 75605-7668 | 2005-05-31 |
| 1922481472 | Radiology Diagnostics | Radiology | 4777 Us Highway 259, Longview, TX 75605-7668 | 2015-07-01 |
| 1407050693 | Kianne Abraham Hardee | Radiology | 700 E Marshall Ave, Longview, TX 75601-5580 | 2007-06-12 |
| 1336245943 | Scott G Bryk | Radiology | 2901 N 4th St, Lrmc - Radiology Department, Longview, TX 75605-5128 | 2006-09-15 |
| 1235178286 | Steven M Urman | Radiology | 1015 Ocean Beach Hwy, #125, Longview, WA 98632-4098 | 2006-06-05 |
| 1902864366 | Medical Imaging Consultants LLP | Radiology | 700 E Marshall Ave, Longview, TX 75601-5580 | 2006-05-03 |
| Find all providers in LONGVIEW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.