Healthcare Provider Details

I. General information

NPI: 1720967656
Provider Name (Legal Business Name): ALEXANDER JOSEPH BISHOP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 PLEASANT ST
DES MOINES IA
50309-1406
US

IV. Provider business mailing address

310 SW 11TH ST UNIT 515
DES MOINES IA
50309-5345
US

V. Phone/Fax

Practice location:
  • Phone: 515-241-3759
  • Fax:
Mailing address:
  • Phone: 515-681-9513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number141151
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: