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General NPI Number Information
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NPI Number | 1396714713
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Entity Type | Individual
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Provider Name | JOHN BARRY BISHOP M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 06/03/2008
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Provider Practice Location Address
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Address Line | 24 MEMORIAL MEDICAL DR
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City | GREENVILLE
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State | SC
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Zip | 29605-4452
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Country | US
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Telephone | 864-295-4160
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Fax | 864-295-0445
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Provider Business Mailing Address
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Address Line | 24 MEMORIAL MEDICAL DR
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City | GREENVILLE
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State | SC
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Zip | 29605-4452
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Country | US
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Telephone | 864-295-4160
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Fax | 864-295-0445
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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 | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 9152
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License Number State | SC
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