Provider Demographics
NPI:1588025746
Name:BISSETT, JOHN SANDERS (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:SANDERS
Last Name:BISSETT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:110 NNPTC CIR
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-6314
Mailing Address - Country:US
Mailing Address - Phone:843-794-6701
Mailing Address - Fax:
Practice Address - Street 1:110 NNPTC CIR
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-6314
Practice Address - Country:US
Practice Address - Phone:843-794-6701
Practice Address - Fax:843-794-6037
Is Sole Proprietor?:No
Enumeration Date:2016-03-16
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2021-02223208D00000X
VA0102204982208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice