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General NPI Number Information
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NPI Number | 1063040046
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Entity Type | Individual
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Provider Name | JOHNRICK PIERCE BISHOP
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Gender | Male
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Dates
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Enumeration Date | 03/27/2020
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 1509 6TH AVE S
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City | BIRMINGHAM
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State | AL
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Zip | 35233-1601
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Country | US
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Telephone | 205-930-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 250 PARK ST
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City | BOWLING GREEN
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State | KY
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Zip | 42101-1760
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 4012
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License Number State | AL
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