Provider Demographics
NPI:1790988194
Name:BUNDY, LISA MUNSCH (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:MUNSCH
Last Name:BUNDY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:401 ALCORN DR
Mailing Address - Street 2:STE 2C
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9073
Mailing Address - Country:US
Mailing Address - Phone:662-293-7266
Mailing Address - Fax:662-293-6255
Practice Address - Street 1:400 TAYLOR RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36117-3512
Practice Address - Country:US
Practice Address - Phone:334-272-1050
Practice Address - Fax:334-271-7698
Is Sole Proprietor?:No
Enumeration Date:2007-06-06
Last Update Date:2018-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL28707207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine