Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 35.135793 | OH |
NPI | 1023428653 |
---|---|
Provider Name | Charles Bishop |
First Address | Gallipolis, OH 45631-1562 |
Second Address | Gallipolis, OH 45631-1560 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2014 |
Last Update Date | 25/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0360453 | (05) | OH |