Provider Demographics
NPI:1982667200
Name:BISHOP, CALVIN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:CALVIN
Middle Name:
Last Name:BISHOP
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 SMYERSTOWN RD
Mailing Address - Street 2:
Mailing Address - City:ROSSITER
Mailing Address - State:PA
Mailing Address - Zip Code:15772-9209
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:115 W MAHONING ST
Practice Address - Street 2:
Practice Address - City:PUNXSUTAWNEY
Practice Address - State:PA
Practice Address - Zip Code:15767-2016
Practice Address - Country:US
Practice Address - Phone:814-938-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009368111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA087652Medicare ID - Type UnspecifiedMEDICARE I.D.