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NPI Code Detail

MEDICARE: DR. MICHAEL ALLEN BIBB MD

MEDICARE: DR. MICHAEL ALLEN BIBB MD
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
1207Q00000XFamily Medicine Physician66026TN

General Provider Information

NPI Number : 1215975792
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL ALLEN BIBB MD
Provider Business Mailing Address
First Line : 1211 UNION AVE STE 330
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-6655
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3725 CHAMPION HILLS DR STE 2000
Second Line :
City : MEMPHIS
State : TN
Zip : 38125-0502
Country : US
Telephone Number : 901-367-9001
Fax Number : 901-565-8787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/04/2006
Last Update Date : 05/01/2025

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