Individual
LARRY BISHOP
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
305 E JEFFERSON ST, SUITE 101, BOISE, ID 83712-6273
(208) 345-0715
(208) 345-1142
Mailing address
305 E JEFFERSON ST, BOISE, ID 83712-6274
(208) 345-0715
(208) 345-1142
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M-3771
ID
Other
Enumeration date
05/06/2006
Last updated
07/08/2007
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