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Physician Compare National (NPI:1508948548)

HEALTHCARE PROVIDER: BILLY JOE BRUNK O.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1508948548
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 1254494834
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20090107000659
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name BRUNK
Individual professional last name
Provider First Name BILLY
Individual professional first name
Provider Middle Name J
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name SOUTHERN COLLEGE OF OPTOMETRY
Individual professional's medical school
Graduation Year 1982
Individual professional's medical school graduation year
Primary Specialty OPTOMETRY
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 816 W CEDAR ST
Group Practice or individual's line 1 address
City STILWELL
Group Practice or individual's city
State OK
Group Practice or individual's state
Zip Code 749603453
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment Y

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