Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0210X | Pediatric Nephrologist | 35.056297 | OH |
Y | 2080P0210X | Pediatric Nephrologist | 50583 | TN |
NPI | 1265500888 |
---|---|
Provider Name | Dr. John J Bissler |
First Address | Memphis, TN 38105 |
Second Address | Memphis, TN 38105 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 16/04/2018 |