MR. JACK P BANDURA MD
NPI 1174628010
Internal Medicine - Cardiovascular Disease in Memphis, TN

Active since September 14, 2006
5959 PARK AVE, MEMPHIS, TN 38119(901) 765-2057(901) 765-2077 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Jack P Bandura Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. JACK P BANDURA MD (NPI 1174628010) is an individual cardiovascular disease provider in Memphis, Tennessee, licensed in Tennessee (9908) and active in the NPI registry since September 2006.

NPPES Registry Identity

NPI1174628010
Entity TypeIndividualMale
Primary Taxonomy207RC0000X
Provider Legal NameMR. JACK P BANDURACredential: MD
Location Address5959 PARK AVEMemphis, TN 38119-5200
Mailing AddressPo Box 1000Memphis, TN 38148-0001 · (901) 523-7019 · Fax (901) 259-4236
Fax(901) 765-2077
Sole ProprietorNo
Enumeration DateSeptember 14, 2006
Last NPPES UpdateJuly 8, 2007
NPI 1174628010 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyInternal Medicine · Cardiovascular DiseaseAllopathic & Osteopathic Physicians
Taxonomy Code207RC0000X
License Licensed in TN · 9908
Definition
An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms.
5959 PARK AVE, Memphis, TN 38119

Other Identifiers 4

Medicare UPINB03167
Other3154736TN · Blue Cross
Medicare ID-Type Unspecified3859780TN
Medicaid3859780TN

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner
5959 PARK AVE
MEMPHIS, TN 38119
Radiology (Diagnostic Radiology)
5959 PARK AVE, RADIOLOGY DEPARTMENT
MEMPHIS, TN 38119
Radiology (Diagnostic Radiology)
5959 PARK AVE, RADIOLOGY DEPARTMENT
MEMPHIS, TN 38119
Physician Assistant (Medical)
5959 PARK AVE
MEMPHIS, TN 38119
Specialist/Technologist, Pathology (Medical Technologist)
5959 PARK AVE
MEMPHIS, TN 38119
Rehabilitation Unit
5959 PARK AVE
MEMPHIS, TN 38119
Nurse Anesthetist, Certified Registered
5959 PARK AVE
MEMPHIS, TN 38119
Physical Therapist
5959 PARK AVE
MEMPHIS, TN 38119

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Bandura's NPI number?

The NPI number for Jack Bandura is 1174628010. It was assigned to this individual provider in the NPPES registry on September 14, 2006.

Where is Jack Bandura located?

Jack Bandura practices at 5959 Park Ave, Memphis, TN 38119. The listed phone number is (901) 765-2057.

What is Jack Bandura's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Cardiovascular Disease, with taxonomy code 207RC0000X.

When was this NPI record last updated?

The NPPES record for Jack Bandura was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.