Provider Demographics
NPI:1629317177
Name:BISHOP, ARCHER WORTMAN JR (M D)
Entity Type:Individual
Prefix:DR
First Name:ARCHER
Middle Name:WORTMAN
Last Name:BISHOP
Suffix:JR
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:4 FOREST CT
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5001
Mailing Address - Country:US
Mailing Address - Phone:865-588-2836
Mailing Address - Fax:865-588-2110
Practice Address - Street 1:4 FOREST CT
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5001
Practice Address - Country:US
Practice Address - Phone:865-588-2836
Practice Address - Fax:865-588-2110
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-04
Last Update Date:2013-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNM D 6175207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery