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General NPI Number Information
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NPI Number | 1528264967
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Entity Type | Individual
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Provider Name | CARL JOSEPH HIBBERT AU.D.
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Gender | Male
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 2657 LAKELAND DR STE B
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City | FLOWOOD
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State | MS
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Zip | 39232-9516
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Country | US
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Telephone | 601-420-4001
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Fax | 601-420-4005
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Provider Business Mailing Address
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Address Line | 5201 LAKELAND BLVD APT P174
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City | FLOWOOD
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State | MS
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Zip | 39232-8916
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Country | US
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Telephone | 601-420-4001
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Fax | 601-420-4005
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number | A2573
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License Number State | MS
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