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Dr. Jerry W Bishop, M.D.

Family Medicine in Dade City, FL. Individual provider (NPI-1).

NPI number1982607875
StatusActive
Last updated in NPPESFeb 10, 2020

Details

NPI
1982607875
Entity type
Individual (NPI-1)
Name
Dr. Jerry W Bishop
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
May 24, 2005
Certification date
Feb 10, 2020
Last updated
Feb 10, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineME92732FLYes

Practice location

13933 17th St Ste 101
Dade City, FL 33525-4604

Phone 352-567-6763 · Fax 352-567-2146

Mailing address

13933 17th St Ste 101
Dade City, FL 33525-4604

Phone 352-567-6763 · Fax 352-567-2146

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