Provider Demographics
NPI:1225188378
Name:BISHOP, LEW D (AUD)
Entity Type:Individual
Prefix:DR
First Name:LEW
Middle Name:D
Last Name:BISHOP
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6908 ECHO VALLEY RD.
Mailing Address - Street 2:
Mailing Address - City:WEST UNION
Mailing Address - State:IA
Mailing Address - Zip Code:52175
Mailing Address - Country:US
Mailing Address - Phone:563-422-5082
Mailing Address - Fax:563-426-5082
Practice Address - Street 1:6908 ECHO VALLEY RD.
Practice Address - Street 2:
Practice Address - City:WEST UNION
Practice Address - State:IA
Practice Address - Zip Code:52175
Practice Address - Country:US
Practice Address - Phone:563-422-5082
Practice Address - Fax:563-426-5082
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA20231H00000X
IA67235Z00000X
IA238237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0143354Medicaid
IA14335Medicare ID - Type Unspecified