Provider Demographics
NPI:1467532937
Name:JON B BISHOP M D P C
Entity Type:Organization
Organization Name:JON B BISHOP M D P C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:801-852-9308
Mailing Address - Street 1:700 W 800 N
Mailing Address - Street 2:SUITE 442
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-6301
Mailing Address - Country:US
Mailing Address - Phone:801-802-0120
Mailing Address - Fax:801-802-0121
Practice Address - Street 1:700 W 800 N
Practice Address - Street 2:SUITE 442
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-6301
Practice Address - Country:US
Practice Address - Phone:801-802-0120
Practice Address - Fax:801-802-0121
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3624831205174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty