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General NPI Number Information
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NPI Number | 1902821531
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Entity Type | Individual
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Provider Name | JOHN H. BISSELL M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/13/2006
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 3910 S CAREFREE CIR STE F
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City | COLORADO SPRINGS
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State | CO
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Zip | 80917-3053
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Country | US
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Telephone | 719-635-3764
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Fax | 719-635-7593
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Provider Business Mailing Address
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Address Line | 1605 N UNION BLVD
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City | COLORADO SPRINGS
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State | CO
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Zip | 80909-2828
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Country | US
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Telephone | 719-635-3764
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Fax | 719-635-7593
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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 | 208VP0000X
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Taxonomy Name | Pain Medicine Physician
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License Number | 27753
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License Number State | CO
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