Provider Demographics
NPI:1902869795
Name:BIBLE, LIZBETH ANNE (MD)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:ANNE
Last Name:BIBLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8769 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-1392
Mailing Address - Country:US
Mailing Address - Phone:937-280-4969
Mailing Address - Fax:937-387-6293
Practice Address - Street 1:8769 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-1392
Practice Address - Country:US
Practice Address - Phone:937-280-4969
Practice Address - Fax:937-387-6293
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-084039207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2538721Medicaid
OH4159839Medicare ID - Type Unspecified
OHI30985Medicare UPIN