Healthcare Provider Details

I. General information

NPI: 1265408975
Provider Name (Legal Business Name): DAVID JOSEPH BICKLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6553 E BAYWOOD AVE SUITE 103
MESA AZ
85206
US

IV. Provider business mailing address

PO BOX 32950
PHOENIX AZ
85015
US

V. Phone/Fax

Practice location:
  • Phone: 480-985-6200
  • Fax: 480-985-2951
Mailing address:
  • Phone: 602-433-1822
  • Fax: 602-246-7060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34784
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: