MEDICARE: WILLIAM ALAN BISHOP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	01090400A	IL

General Provider Information

NPI Number	:	1235633389
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ALAN BISHOP

Provider Business Mailing Address
First Line	:	213 FREEDOM LN
Second Line	:
City	:	WATERVILLE
State	:	OH
Zip	:	43566-1141
Country	:	US
Telephone Number	:	419-277-0576
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 GOOD SAMARITAN WAY STE 235
Second Line	:
City	:	MOUNT VERNON
State	:	IL
Zip	:	62864-2476
Country	:	US
Telephone Number	:	618-899-3980
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/22/2018
Last Update Date	:	12/04/2025

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Directions to “ WILLIAM ALAN BISHOP ” Practice Location

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