Provider Demographics
NPI:1013902782
Name:BISHOP, ROBERT G (MD)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:G
Last Name:BISHOP
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:397 WALLACE RD
Mailing Address - Street 2:BLDG C SUITE 100
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37211-4854
Mailing Address - Country:US
Mailing Address - Phone:615-834-6166
Mailing Address - Fax:615-781-9755
Practice Address - Street 1:397 WALLACE RD
Practice Address - Street 2:BLDG C SUITE 100
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37211-4854
Practice Address - Country:US
Practice Address - Phone:615-834-6166
Practice Address - Fax:615-781-9755
Is Sole Proprietor?:No
Enumeration Date:2005-09-19
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD19669207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3081440Medicaid
TN3081440Medicaid
TN3081445Medicare ID - Type Unspecified