Individual
JAY R BISHOP
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
350 W COUNTRY CLUB RD, SUITE#205, ROSWELL, NM 88201-5205
(575) 622-7593
(575) 622-5538
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
46011
WI
208800000X
Urology Physician
Primary
A-1577-10
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00040021
—
NM
01
—
13590
DEAN
WI
01
—
390807236AE
UNITY
WI
05
—
43509400
—
WI
01
—
46011
TOUCHPOINT
WI
01
—
NPI & TIN#
BCBS OF NM
NM
01
—
P00061174
RAILROAD MEDICARE
WI
01
—
WI01K8
JOHN DEERE
WI
Enumeration date
10/26/2005
Last updated
01/13/2025
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