Provider Demographics
NPI:1790429785
Name:TROY W BISHOP MD LLC
Entity Type:Organization
Organization Name:TROY W BISHOP MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:TROY
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-545-2272
Mailing Address - Street 1:9417 BROADVIEW RD
Mailing Address - Street 2:
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2307
Mailing Address - Country:US
Mailing Address - Phone:440-545-2272
Mailing Address - Fax:440-545-5645
Practice Address - Street 1:9417 BROADVIEW RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2307
Practice Address - Country:US
Practice Address - Phone:440-545-2272
Practice Address - Fax:440-545-5645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty