Provider Demographics
NPI:1316831837
Name:BISHOP, WILLIAM ROMEO JR
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:ROMEO
Last Name:BISHOP
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 RAILROAD AVE STE D62
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-7509
Mailing Address - Country:US
Mailing Address - Phone:808-746-4476
Mailing Address - Fax:
Practice Address - Street 1:64 KEAWE ST STE 205
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2486
Practice Address - Country:US
Practice Address - Phone:808-464-5576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-09
Last Update Date:2025-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMAT17682225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist