# JOHN S BICKLE DO PLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Black Mountain Family Medicine
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861522419
- **Authorized official:** DR. JOHN BICKLE DO (PRESIDENT)
- **Authorized official phone:** (480) 595-8900

## Contact information

- **Practice address:** 33755 N SCOTTSDALE RD, SUITE 120, SCOTTSDALE, AZ 85266-1567
- **Practice address phone:** (480) 595-8900
- **Practice address fax:** (480) 595-8910
- **Mailing address:** 33755 N SCOTTSDALE RD, SUITE 120, SCOTTSDALE, AZ 85266-1567
- **Mailing address phone:** (480) 595-8900
- **Mailing address fax:** (480) 595-8910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 30905 | AZ | Yes |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 05/19/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | AZ0714850 | BLUE CROSS | AZ |