Provider Demographics
NPI:1982464244
Name:HIBBARD, BRIAN ROBERT (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:ROBERT
Last Name:HIBBARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 ABRAHAM FLEXNER WAY RM 1531
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-3826
Mailing Address - Country:US
Mailing Address - Phone:502-588-4707
Mailing Address - Fax:502-852-6064
Practice Address - Street 1:220 ABRAHAM FLEXNER WAY RM 1531
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-3826
Practice Address - Country:US
Practice Address - Phone:502-588-4707
Practice Address - Fax:502-852-6064
Is Sole Proprietor?:No
Enumeration Date:2024-03-21
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program