Provider Demographics
NPI:1922113414
Name:BISHOP, JOSEPH A (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PETERS ST
Mailing Address - Street 2:SUITE 38
Mailing Address - City:CALHOUN
Mailing Address - State:GA
Mailing Address - Zip Code:30701-2735
Mailing Address - Country:US
Mailing Address - Phone:706-625-2855
Mailing Address - Fax:706-625-5698
Practice Address - Street 1:100 PETERS ST
Practice Address - Street 2:SUITE 38
Practice Address - City:CALHOUN
Practice Address - State:GA
Practice Address - Zip Code:30701-2735
Practice Address - Country:US
Practice Address - Phone:706-625-2855
Practice Address - Fax:706-625-5698
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA010372207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D39413Medicare UPIN