JOHN L BUNDRICK (NPI# 1265791784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265791784 |
| Entity Type | Individual |
| Full Name | JOHN L BUNDRICK |
| Credential | M.D. |
| Practice Address |
705 Dixie Street Carrollton GA 30117 |
| Mailing Address |
P.o. Box 639219 Cincinnati OH 45263-9219 |
| Practice Telephone | 7708340751 |
| Practice Fax Number | 7708340753 |
| Mailing Telephone | 7708340751 |
| Mailing Fax Number | 7708340753 |
| Enumeration Date | 2012-05-04 |
| Last Update Date | 2018-06-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
080497 | GA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235679770 | John Bundrick | Counselor | 2100 S Cherry St Ste 204, Denver, CO 80222-5037 | 2017-03-02 |
| 1396953303 | John Daniel Bundrick | Pharmacist | 1426 Main St, Mc 11p, Columbia, SC 29201-5804 | 2007-05-21 |
| 1275513632 | John B Bundrick | Internal Medicine | 200 1st St Sw, Rochester, MN 55905-0001 | 2006-01-20 |
| Street Address |
705 DIXIE STREET |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629058573 | William Evan Rogers Sr. | Internal Medicine | 705 Dixie Street, Ste 401, Carrollton, GA 30117 | 2006-01-18 |
| 1669034500 | Lauren Elizabeth Tetlow | Nurse Practitioner | 705 Dixie Street, Carrollton, GA 30117 | 2019-07-01 |
| 1578985271 | Rebecca Jill Pope | Nurse Practitioner | 705 Dixie Street, Carrollton, GA 30117 | 2014-01-14 |
| 1871841437 | Sarah Elizabeth Worthy | Physician Assistant | 705 Dixie Street, Carrollton, GA 30117-3818 | 2012-08-29 |
| 1801186689 | Sagar M Patel | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2011-04-13 |
| 1538497300 | Richard E Rosebrock | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2009-12-06 |
| 1356502538 | Brian D. Weber | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2008-06-20 |
| 1023278421 | Kandra S Vogt | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2008-06-10 |
| 1093868952 | Robert S Hyslop | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2007-01-22 |
| 1083689251 | Georgia West Imaging, PC | Radiology | 705 Dixie Street, Carrollton, GA 30117-3816 | 2006-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104174739 | Ritz Hospitality, LLC | Radiology | 1520 Blue Mesa Dr, Carrollton, TX 75007-6022 | 2012-08-29 |
| 1508989088 | Timothy Neal Ozburn | Radiology | 119 Maple St Ste 205, Carrollton, GA 30117-3259 | 2007-04-09 |
| 1093742694 | Alexandre Morin | Radiology | 119 Maple St, Suite 205, Carrollton, GA 30117-3230 | 2006-06-27 |
| 1962467647 | Gmn Associates | Radiology | 4343 N Josey Lane, Carrollton, TX 75010 | 2006-04-18 |
| 1801186689 | Sagar M Patel | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2011-04-13 |
| 1538497300 | Richard E Rosebrock | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2009-12-06 |
| 1356502538 | Brian D. Weber | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2008-06-20 |
| 1023278421 | Kandra S Vogt | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2008-06-10 |
| 1093868952 | Robert S Hyslop | Radiology | 705 Dixie Street, Carrollton, GA 30117 | 2007-01-22 |
| 1881753291 | William Edwin Behm | Radiology | 705 Dixie St, Carrollton, GA 30117-3818 | 2006-12-08 |
| Find all providers in CARROLLTON | ||||
| City | CARROLLTON |
| Zip Code | 30117 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.