MEDICARE: JOHN S BICKLE DO PLC

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	30905	AZ

Other Identifiers

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

General Provider Information

NPI Number	:	1861522419
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOHN S BICKLE DO PLC

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

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN BICKLE
Credential	:	DO
Telephone Number	:	480-595-8900

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	05/19/2008

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Directions to “JOHN S BICKLE DO PLC ” Practice Location

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