| Dr. Daniel Bishop | |
|
415 Broad St Ste 2 Lake Geneva WI 53147-1800 | |
| (262) 374-3444 | |
| (844) 247-2735 |
| Full Name | Dr. Daniel Bishop |
|---|---|
| Speciality | Psychologist |
| Location | 415 Broad St Ste 2, Lake Geneva, Wisconsin |
| Authorized Official Name and Position | Daniel Wayne Bishop (OWNER) |
| Authorized Official Contact | 2623743444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Daniel Bishop 415 Broad St Ste 2 Lake Geneva WI 53147-1800 Ph: (262) 374-3444 | Dr. Daniel Bishop 415 Broad St Ste 2 Lake Geneva WI 53147-1800 Ph: (262) 374-3444 |
| NPI Number | 1790316347 |
|---|---|
| Provider Enumeration Date | 02/03/2020 |
| Last Update Date | 03/18/2022 |
| Certification Date | 03/18/2022 |
| Medicare PECOS PAC ID | 7618308487 |
|---|---|
| Medicare Enrollment ID | O20200511002560 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790316347 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | (* (Not Available)) | Primary |
| Provider Name | Daniel Wayne Bishop |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215039201 PECOS PAC ID: 3072836360 Enrollment ID: I20160809000902 |
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