Provider Demographics
NPI:1437283876
Name:BUNDY, JAMES W (DPH, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:W
Last Name:BUNDY
Suffix:
Gender:M
Credentials:DPH, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1018 GREEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-5200
Mailing Address - Country:US
Mailing Address - Phone:731-642-6840
Mailing Address - Fax:731-642-9879
Practice Address - Street 1:1027 MINERAL WELLS AVE
Practice Address - Street 2:STE. #2
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242-4905
Practice Address - Country:US
Practice Address - Phone:731-642-6840
Practice Address - Fax:732-642-9879
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNC-411183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist