Individual
JOHN L BUNDRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
705 DIXIE STREET, CARROLLTON, GA 30117
(770) 834-0751
(770) 834-0753
Mailing address
P.O. BOX 639219, CINCINNATI, OH 45263-9219
(770) 834-0751
(770) 834-0753
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
080497
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/04/2012
Last updated
06/26/2018
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