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Contact Information

CHARLES G BISHOP JR, MD
12 GINGER CREEK PARKWAY
GLEN CARBON, IL62034
 Phone: 618-656-8200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
 

Pain Medicine

207LP2900X 05 Physician/Anesthesiology
Indicates primary specialty

NPI Profile & details for CHARLES G BISHOP JR · (Male)

NPI Number 1629053459
Status Active
Credentials MD
Entity Individual
Enumeration date 12/14/2005
Last updated 12/26/2014 - About 11 years ago
Sole proprietor 1 Yes
Identifiers
  • IL License # 036106182
  • IL Medicaid 036106182
Hospital affiliation(s)
  • WAYNE MEMORIAL HOSPITAL - (Acute Care)
    865 SOUTH FIRST STREET
    JESUP, GA 31545
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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