Individual
KATHLEEN E MOORE BISHOP
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1800 E FLORENCE BLVD, CASA GRANDE, AZ 85122-5303
(520) 381-6105
(520) 381-6060
Mailing address
8180 E OCOTILLO DR, TUCSON, AZ 85750-9665
(520) 749-3771
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25817
AZ
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
Primary
25817
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220806
INDIVIDUAL AHCCCS ID#
—
Enumeration date
05/18/2007
Last updated
05/01/2017
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