Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Micky Kyler Bacchus, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1386574267

Dr. Micky Kyler Bacchus, DO is a Student in an Organized Health Care Education/Training Program in Philadelphia, Pennsylvania. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

5501 Old York Rd Ste 1
Philadelphia, PA 19141-3098
Phone: (215) 456-7190
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1386574267
Entity typeIndividual (Type 1)
GenderFemale
Credentials DO
Sole proprietorNo
NPI enumeratedMay 21, 2026
Last updated in NPPESMay 21, 2026
Certification dateMay 21, 2026

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