Healthcare Provider Details
I. General information
NPI: 1831279132
Provider Name (Legal Business Name): MICHAEL C BIBLER DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 10/17/2006
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 S COULTER ST STE 200
AMARILLO TX
79106-1841
US
IV. Provider business mailing address
816 22ND AVE SUITE 100
KEARNEY NE
68845-2206
US
V. Phone/Fax
- Phone: 806-212-6604
- Fax:
- Phone: 308-865-2808
- Fax: 308-455-3970
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208G00000X |
| Taxonomy | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician |
| License Number | 291 |
| License Number State | NE |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: