Provider Demographics
NPI:1184634362
Name:GERALDINE BISHOP PHD PC INC
Entity Type:Organization
Organization Name:GERALDINE BISHOP PHD PC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:GERALDINE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:901-388-1893
Mailing Address - Street 1:1540 APPLING CARE LANE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38016
Mailing Address - Country:US
Mailing Address - Phone:901-388-1893
Mailing Address - Fax:901-388-1995
Practice Address - Street 1:1540 APPLING CARE LANE
Practice Address - Street 2:SUITE 100
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016
Practice Address - Country:US
Practice Address - Phone:901-388-1893
Practice Address - Fax:901-388-1995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTN452103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3982523Medicare PIN