Provider Demographics
NPI:1164519559
Name:HIBBS, JOHN B JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:B
Last Name:HIBBS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:5347 COTTONWOOD LN
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-7605
Mailing Address - Country:US
Mailing Address - Phone:801-272-1285
Mailing Address - Fax:801-584-5623
Practice Address - Street 1:500 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84148-0001
Practice Address - Country:US
Practice Address - Phone:801-582-1565
Practice Address - Fax:801-584-5623
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
UT158813-1205207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease