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General NPI Number Information
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NPI Number | 1073761441
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Entity Type | Organization
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Legal Business Name | BISHOP FAMILY MEDICINE, P.C.
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Dates
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Enumeration Date | 08/28/2008
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Last Update Date | 08/28/2008
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Provider Practice Location Address
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Address Line | 9984 MARTIN AVE
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City | LAKE CITY
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State | PA
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Zip | 16423-1527
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Country | US
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Telephone | 814-774-3495
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Fax | 814-774-3497
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Provider Business Mailing Address
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Address Line | 9984 MARTIN AVE
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City | LAKE CITY
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State | PA
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Zip | 16423-1527
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Country | US
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Telephone | 814-774-3495
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Fax | 814-774-3497
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Authorized Official
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Title or Position | OWNER
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Name | DR. DEBORAH E BISHOP
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Credential | MD
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Telephone | 814-774-3495
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD056630L
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License Number State | PA
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