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NPI Code Detail

MEDICARE: JAMIE REYES MCKIBBEN

MEDICARE: JAMIE REYES MCKIBBEN
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
1374J00000XDoulaAZ

General Provider Information

NPI Number : 1922961317
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE REYES MCKIBBEN
Provider Business Mailing Address
First Line : 7310 E PLACITA MINA
Second Line :
City : TUCSON
State : AZ
Zip : 85710-3736
Country : US
Telephone Number : 520-904-8211
Fax Number :
Provider Business Practice Location Address
First Line : 7310 E PLACITA MINA
Second Line :
City : TUCSON
State : AZ
Zip : 85710-3736
Country : US
Telephone Number : 520-904-8211
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ JAMIE REYES MCKIBBEN ” Practice Location

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