Provider Demographics
NPI:1346263860
Name:BISHOP, STEPHEN JOHN (MD)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:JOHN
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 461170
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-5170
Mailing Address - Country:US
Mailing Address - Phone:303-759-3173
Mailing Address - Fax:303-388-7356
Practice Address - Street 1:720 S COLORADO BLVD
Practice Address - Street 2:SUITE 455S
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-1904
Practice Address - Country:US
Practice Address - Phone:303-759-3173
Practice Address - Fax:303-388-7356
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO223712084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01223718Medicaid
COD24087Medicare UPIN