Provider Demographics
NPI:1073705810
Name:LIZBETH BIBLE, MD, INC
Entity Type:Organization
Organization Name:LIZBETH BIBLE, MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZBETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:BIBLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:937-890-8580
Mailing Address - Street 1:8662 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1328
Mailing Address - Country:US
Mailing Address - Phone:937-890-8580
Mailing Address - Fax:937-890-9652
Practice Address - Street 1:8662 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1328
Practice Address - Country:US
Practice Address - Phone:937-890-8580
Practice Address - Fax:937-890-9652
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35084039207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2538721Medicaid
OH4159839Medicare PIN
OHI30985Medicare UPIN