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NPI Code Detail

MEDICARE: DR. JOHN H. BISSELL M.D.

MEDICARE:  DR. JOHN H. BISSELL  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208VP0000XPain Medicine Physician27753CO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1902821531
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN H. BISSELL M.D.
Provider Business Mailing Address
First Line : 1605 N UNION BLVD
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80909-2828
Country : US
Telephone Number : 719-635-3764
Fax Number : 719-635-7593
Provider Business Practice Location Address
First Line : 3910 S CAREFREE CIR STE F
Second Line :
City : COLORADO SPRINGS
State : CO
Zip : 80917-3053
Country : US
Telephone Number : 719-635-3764
Fax Number : 719-635-7593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2006
Last Update Date : 10/09/2024

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Directions to “ DR. JOHN H. BISSELL M.D.” Practice Location

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