Healthcare Provider Details

I. General information

NPI: 1881733889
Provider Name (Legal Business Name): JOHN LUIS BIBB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 02/25/2026
Certification Date: 02/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10460 N 92ND ST # 200-400
SCOTTSDALE AZ
85258-4549
US

IV. Provider business mailing address

10460 N 92ND ST # 200-400
SCOTTSDALE AZ
85258-4549
US

V. Phone/Fax

Practice location:
  • Phone: 623-238-7630
  • Fax: 480-278-8828
Mailing address:
  • Phone: 623-238-7630
  • Fax: 480-278-8828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number36673
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number36673
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: