Provider Demographics
NPI:1528220233
Name:BISHOP, CURTIS MATHEW (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:MATHEW
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6747 US HWY 98
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-3108
Mailing Address - Country:US
Mailing Address - Phone:601-337-3822
Mailing Address - Fax:769-307-0143
Practice Address - Street 1:6747 US HWY 98
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39402-3108
Practice Address - Country:US
Practice Address - Phone:601-337-3822
Practice Address - Fax:769-307-0143
Is Sole Proprietor?:No
Enumeration Date:2008-06-25
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS3465-081223S0112X
390200000X
MSOS-485-141223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program