Provider Demographics
NPI:1124046768
Name:HIBBARD, ASHLEY B (MSPT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:B
Last Name:HIBBARD
Suffix:
Gender:F
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7191 CAHABA VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6402
Mailing Address - Country:US
Mailing Address - Phone:205-408-6555
Mailing Address - Fax:205-408-6570
Practice Address - Street 1:7191 CAHABA VALLEY RD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6402
Practice Address - Country:US
Practice Address - Phone:205-408-6555
Practice Address - Fax:205-408-6570
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2014-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH4306225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1003819608OtherGROUP NPI
AL529917620Medicaid
AL051528425HIBOtherMEDICARE ID-TYPE UNSPECIFIED
AL515-28425OtherBCBS PROVIDER NUMBER
ALK531Medicare UPIN
AL529917620Medicaid