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1174628010
JACK P BANDURA
MEMPHIS, TN
NPI
1174628010
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207RC0000X Internal Medicine, Cardiovascular Disease
(Licence: TN 9908)
Enumeration Date
2006-09-14
Last Update Date
2007-07-08
Business Address
Mr. JACK P BANDURA MD
5959 PARK AVE
MEMPHIS, TN 38119-5200
Phone number: 901-765-2057
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Mailing Address
Mr. JACK P BANDURA MD
PO BOX 1000
MEMPHIS, TN 38148-0001
Phone number: 901-523-7019
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