Provider Demographics
NPI:1578190765
Name:BISCHOFF, ALEX JAMES (DPM)
Entity Type:Individual
Prefix:
First Name:ALEX
Middle Name:JAMES
Last Name:BISCHOFF
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:14200 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:OH
Mailing Address - Zip Code:44107-4510
Mailing Address - Country:US
Mailing Address - Phone:216-658-0111
Mailing Address - Fax:216-658-0110
Practice Address - Street 1:7580 AUBURN RD STE 309
Practice Address - Street 2:
Practice Address - City:CONCORD TOWNSHIP
Practice Address - State:OH
Practice Address - Zip Code:44077-9618
Practice Address - Country:US
Practice Address - Phone:216-658-0111
Practice Address - Fax:216-658-0110
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-26
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36.004091213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty