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General NPI Number Information
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NPI Number | 1992962393
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Entity Type | Organization
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Legal Business Name | DR. BUNDY AND ASSOCIATES, LLC
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Dates
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Enumeration Date | 05/22/2008
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Last Update Date | 05/22/2008
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Provider Practice Location Address
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Address Line | 1919 STATE ST SUITE 362
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City | NEW ALBANY
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State | IN
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Zip | 47150-4929
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Country | US
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Telephone | 812-944-5888
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Fax | 812-944-6111
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Provider Business Mailing Address
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Address Line | 1919 STATE ST SUITE 362
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City | NEW ALBANY
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State | IN
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Zip | 47150-4929
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Country | US
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Telephone | 812-944-5888
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Fax | 812-944-6111
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Authorized Official
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Title or Position | DOCTOR
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Name | MARY L BUNDY
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Credential | MD
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Telephone | 812-944-5888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 01037496A
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License Number State | IN
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