Provider Demographics
NPI:1700068913
Name:JOHN D. BISHOP, O. D., INC.
Entity Type:Organization
Organization Name:JOHN D. BISHOP, O. D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:BISHOP
Authorized Official - Suffix:
Authorized Official - Credentials:O D
Authorized Official - Phone:405-751-8851
Mailing Address - Street 1:2818 W BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-4428
Mailing Address - Country:US
Mailing Address - Phone:405-751-8851
Mailing Address - Fax:
Practice Address - Street 1:2818 W BRITTON RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-4428
Practice Address - Country:US
Practice Address - Phone:405-751-8851
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-29
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK0327660001OtherDME SUPPLIER MEDICARE
OK0327660001Medicare NSC
OKOKB5262Medicare PIN