Healthcare Provider Details

I. General information

NPI: 1922724525
Provider Name (Legal Business Name): DCB MEDICAL PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2022
Last Update Date: 10/14/2022
Certification Date: 10/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23706 W LA CANADA BLVD
BUCKEYE AZ
85396-6392
US

IV. Provider business mailing address

23706 W LA CANADA BLVD
BUCKEYE AZ
85396-6392
US

V. Phone/Fax

Practice location:
  • Phone: 623-326-4260
  • Fax:
Mailing address:
  • Phone: 623-326-4260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MR. DOUGLAS CHRISTIAN BISHOP
Title or Position: OWNER
Credential: FNP-C
Phone: 623-326-4260