John B Hibbs Jr., MD

Key facts

NPI

1164519559

Entity type

Individual (NPI type 1)

Primary specialty

Infectious Disease Physician 207RI0200X

License

158813-1205 (UT)

Practice address

500 Foothill Blvd
Salt Lake City, UT 84148-0001

Phone

(801) 582-1565

Fax

(801) 584-5623

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

No

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Doctor of Medicine

State licenses

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164519559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5347 COTTONWOOD LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841177605",
            "telephone_number": "801-272-1285",
            "fax_number": "801-584-5623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FOOTHILL BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841480001",
            "telephone_number": "801-582-1565",
            "fax_number": "801-584-5623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBS",
        "first_name": "JOHN",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "UT",
            "license": "158813-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Robert Hibbard, MD
• Ellen Grace Hibdon
• Kaleb Hibdon
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• Anna Hicken
• Bret Hicken

All providers in Salt Lake City, UT · Infectious Disease Physician in Utah