Healthcare Provider Details

I. General information

NPI: 1487642716
Provider Name (Legal Business Name): ROBERT ALLYN BISCHOFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 9TH AVE
BELLE PLAINE IA
52208-2200
US

IV. Provider business mailing address

105 9TH AVE
BELLE PLAINE IA
52208-2200
US

V. Phone/Fax

Practice location:
  • Phone: 319-444-3210
  • Fax: 319-444-1078
Mailing address:
  • Phone: 319-444-3210
  • Fax: 319-444-1078

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number26642
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: