Healthcare Provider Details

I. General information

NPI: 1437283876
Provider Name (Legal Business Name): JAMES W. BUNDY DPH., PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 MINERAL WELLS AVE STE. #2
PARIS TN
38242-4905
US

IV. Provider business mailing address

1018 GREEN VALLEY DR
PARIS TN
38242-5200
US

V. Phone/Fax

Practice location:
  • Phone: 731-642-6840
  • Fax: 732-642-9879
Mailing address:
  • Phone: 731-642-6840
  • Fax: 731-642-9879

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberC-411
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: