Provider Demographics
NPI:1457428492
Name:BISHOP, PAUL STEPHAN (DPM)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:STEPHAN
Last Name:BISHOP
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7304 E DEER VALLEY RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-7459
Mailing Address - Country:US
Mailing Address - Phone:480-342-9999
Mailing Address - Fax:480-342-7169
Practice Address - Street 1:7304 E DEER VALLEY RD STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-7459
Practice Address - Country:US
Practice Address - Phone:480-342-9999
Practice Address - Fax:480-342-7169
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZPOD-001101213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
L70412Medicare ID - Type Unspecified
U62406Medicare UPIN