Provider Demographics
NPI:1437525185
Name:BISHOP, CLIFTON (PD)
Entity Type:Individual
Prefix:MR
First Name:CLIFTON
Middle Name:
Last Name:BISHOP
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 W COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:TN
Mailing Address - Zip Code:38574-1107
Mailing Address - Country:US
Mailing Address - Phone:931-839-2207
Mailing Address - Fax:931-839-3746
Practice Address - Street 1:101 W COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:TN
Practice Address - Zip Code:38574-1107
Practice Address - Country:US
Practice Address - Phone:931-839-2207
Practice Address - Fax:931-839-3746
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5758183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist