Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACK EDWARD RUNNELS, DO
Active Sole ProprietorSports Medicine · CONCORD, NC
Registration Details
- NPI Number
- 1710627617
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 30, 2022 (4.0642309457568 yrs)
- Last Updated
- Aug 25, 2025
- License
-
2025-01850 (NC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
5651 POPLAR TENT RD STE 102CONCORD, NC, 280277686Browse NC providers · Browse ZIP 28027
- Phone
- 7047824878
- Primary Specialty
-
Sports Medicine
207QS0010X
Other Sports Medicine Providers in CONCORD, NC
| Name | Credential | NPI |
|---|---|---|
| KATHERINE WALKER FOSTER | MD | 1275521080 |
| BRENT HAMILTON MESSICK | MD | 1215137831 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.