MEDICARE: DR. JOHN SCOTT BICKLE D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	3095	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1Z4330	OTHER	AZ	HEALTHNET
2	AZ0714850	OTHER	AZ	BLUE CROSS

General Provider Information

NPI Number	:	1134136591
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN SCOTT BICKLE D.O.

Provider Business Mailing Address
First Line	:	33755 N SCOTTSDALE RD STE 120
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-1567
Country	:	US
Telephone Number	:	480-595-8900
Fax Number	:	480-595-8910

Provider Business Practice Location Address
First Line	:	33755 N SCOTTSDALE RD STE 120
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85266-1567
Country	:	US
Telephone Number	:	480-595-8900
Fax Number	:	480-595-8910

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	03/25/2008

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Directions to “ DR. JOHN SCOTT BICKLE D.O.” Practice Location

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