Individual
MARILYN A BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
200 MED TECH PKWY, SUITE 108, JOHNSON CITY, TN 37604-2278
(423) 915-5033
(423) 952-3777
Mailing address
200 MED TECH PKWY, SUITE 108, JOHNSON CITY, TN 37604-2278
(423) 915-5033
(423) 952-3777
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
MD21539
TN
208D00000X
General Practice Physician
MD21539
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134185739
—
VA
05
—
3062667
—
TN
01
—
3074352
BCBS
TN
05
—
Q003169
—
TN
Enumeration date
04/22/2006
Last updated
01/27/2017
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