Bishop, Jerry W

Bishop, Jerry W is an individual health care provider with primary practice located at 13933 17Th St Ste 101 , Dade City FL 33525-4604. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bishop, Jerry W can be contacted via phone (352) 567-6763.

Contact Information

Primary practice address
13933 17Th St Ste 101 Dade City FL 33525-4604
Phone: (352) 567-6763
Fax: (352) 567-2146
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X ME92732 Florida

Profile Details

NPI number 1982607875
LBN Legal business name Bishop, Jerry W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 24th, 2005
Last updated Feb 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982607875 NPPES
Florida MEDICAID 272805200
Florida Other P00652865

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