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NPI Code Detail

MEDICARE: JAMES MITCHELL HIBBARD MPAS, P.A.-C

MEDICARE: JAMES MITCHELL HIBBARD MPAS, P.A.-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant345080-1206UT

General Provider Information

NPI Number : 1811916679
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES MITCHELL HIBBARD MPAS, P.A.-C
Provider Business Mailing Address
First Line : 2368 KIESEL AVE
Second Line :
City : OGDEN
State : UT
Zip : 84401-1964
Country : US
Telephone Number : 385-483-4649
Fax Number :
Provider Business Practice Location Address
First Line : 2368 KIESEL AVE
Second Line :
City : OGDEN
State : UT
Zip : 84401-1964
Country : US
Telephone Number : 385-483-4649
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/19/2006
Last Update Date : 07/31/2025

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