Healthcare Provider Details

I. General information

NPI: 1912956202
Provider Name (Legal Business Name): LINDSAY K BISHOP JR. PA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: LINDSAY BISHOP

II. Dates (important events)

Enumeration Date: 05/06/2006
Last Update Date: 12/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10400 RAMSEY WAY
DICKSON TN
37055
US

IV. Provider business mailing address

131 SAUNDERSVILLE ROAD SUITE 160
HENDERSONVILLE TN
37075
US

V. Phone/Fax

Practice location:
  • Phone: 615-824-3737
  • Fax: 888-295-0304
Mailing address:
  • Phone: 615-824-3737
  • Fax: 888-687-6133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA11
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: